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Related Experiment Videos

[Iatrogenic biliovenous fistula].

H Maxeiner

    Zeitschrift Fur Rechtsmedizin. Journal of Legal Medicine
    |January 1, 1984
    PubMed
    Summary

    A rare biliovenous fistula caused severe jaundice and organ failure after bile duct scanning. Despite interventions, the patient died from complications including cholemic nephrosis and gastrointestinal bleeding.

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    Area of Science:

    • Gastroenterology
    • Surgical Complications
    • Biliary System Imaging

    Background:

    • A 44-year-old male patient presented with a history of cholecystolithiasis and recurrent jaundice.
    • Cholecystectomy was performed, followed by radiomanometric scanning of the bile ducts due to obstruction.

    Observation:

    • Postoperatively, the patient experienced worsening jaundice, with serum bilirubin reaching 742 mumol/l.
    • A small biliovenous fistula was identified as the cause of persistent icterus.
    • Multiple surgical and endovascular attempts to manage the fistula were unsuccessful.

    Findings:

    • The patient developed renal failure, coagulation disturbances, and circulatory/respiratory insufficiency.
    • Autopsy revealed massive jaundice, gastrointestinal bleeding, and cholemic nephrosis.
    • A 20 x 8 x 15 mm fistula was found in the right hepatic lobe, connecting a hepatic duct branch to a hepatic vein.

    Implications:

    • This case highlights a rare but fatal complication of biliary duct scanning.
    • Accidental catheter deviation during scanning can lead to biliovenous fistula formation.
    • Prolonged bilhemia resulting from such fistulas can cause multi-organ failure and death.

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