Abstract
A 68-year-old woman was admitted to our hospital with obstructive jaundice. Abdominal CT scan demonstrated a mass at the head of the pancreas. The patient was diagnosed as having obstructive jaundice caused by pancreatic cancer. We tried to relieve the bile duct obstruction by ERCP (endoscopic retrograde cholangiopancreatography). After several cannulation attempts, we thought that we had achieved deep cannulation of the bile duct and tried to place a biliary plastic stent. During ERCP, however, we noticed massive air in the portal venous system, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography revealed air in the portal venous system. Fortunately, there were no subsequent complications. The air in the portal vein had disappeared, ascertained by CT scan taken 5 days later. The patient underwent surgical resection for pancreatic cancer. Isolated portal vein cannulation per se does not usually result in mortality or serious morbidity.
국내에서 내시경역행성췌담도조영술 시행 중 간문맥 삽관이 보고된 증례는 없었다. 황달이 발생한 췌장 두부암 환자에서 내시경역행성췌담도조영술 중 유도선을 따라 삽관 캐뉼라를 삽입하였으나 간문맥 내 삽관이 발생하여 시술을 중단하고 보존적 치료를 통하여 회복된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.