Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Hepatol. Oct 27, 2012; 4(10): 288-290
Published online Oct 27, 2012. doi: 10.4254/wjh.v4.i10.288
Peritoneal bleeding due to percutaneous transhepatic gallbladder drainage: An autopsy report
Yoko Ihama, Maki Fukazawa, Kenji Ninomiya, Takumi Nagai, Chiaki Fuke, Tetsuji Miyazaki
Yoko Ihama, Maki Fukazawa, Kenji Ninomiya, Takumi Nagai, Chiaki Fuke, Tetsuji Miyazaki, Department of Forensic Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
Author contributions: Ihama Y, Fukazawa M and Ninomiya K performed the macroscopic and microscopic examination; Nagai T, Fuke C and Miyazaki T gave clinical and general advices.
Correspondence to: Yoko Ihama, MD, PhD, Department of Forensic Medicine, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan. makino@med.u-ryukyu.ac.jp
Telephone: +81-98-8951141 Fax: +81-98-8951413
Received: February 14, 2012
Revised: October 15, 2012
Accepted: October 22, 2012
Published online: October 27, 2012
Abstract

A 77-year-old man underwent percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis as a preoperative procedure; however, he suddenly suffered cardiopulmonary arrest 4 h after the PTGBD and died. There were three centesis scars for the PTGBD, and only one pathway from the most dorsal centesis scar reached the gallbladder. Microscopically, the PTGBD pathway crossed and injured the intrahepatic arterial wall, and hepatic parenchymal bleeding extended along the PTGBD pathway to the inferior surface of the liver. Blood flowed to the peritoneal cavity through a small gap between the liver and gallbladder. Consequently, the PTGBD caused lethal bleeding. When the percutaneous transhepatic cholangio drainage/PTGBD pathway runs close to vessels near the liver surface, it might be necessary to deal with the possibility of rapid and lethal peritoneal bleeding.

Keywords: Percutaneous transhepatic gallbladder drainage; Percutaneous transhepatic cholangio drainage; Lethal complication; Autopsy