Obstructive jaundice with biliary fungal infection in 2 cases reported _1889

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Obstructive jaundice with biliary fungal infection in 2 cases reported
 
 
Affiliated Hospital of Zhengzhou 4,500,521 for a typical case of a medical history: female patient, aged 60, to Admitted to hospital in February antecedents of anorexia, fatigue treatment, B-Tip cholangiocarcinoma with liver metastasis, hepatic artery embolization, progressive jaundice after 1 month of symptoms, stool white pottery earth tones, B-prompted expansion of intrahepatic bile duct, common bile duct Upper solid mass and multiple nodular liver placeholder. Liver function tests TBIL139p_mol / L, DBIL77.2p. mol / L, IBIL62.1p. mol / L, GGT135U / L, ALP326U / L. Blood to normal. After aggressive preoperative preparation, C-arm down percutaneous transhepatic biliary drainage (PrcD) surgery, intraoperative bile duct biopsy, placed inside and outside the drainage tube. Unobstructed drainage after surgery. Pathological results suggest that fungi bacteria group. Application Diflucan antifungal treatment. Reduce postoperative jaundice, symptoms recovered well, review GGT7U / L, ALP116U / L, TBIL24/mlol/L. Case 2: male patients, aged 72,You are not allowed to view links. Register or Login, to gradually increase the B-check prompt gallbladder stones, cholecystectomy,You are not allowed to view links. Register or Login, pathology is unknown. Postoperative jaundice and progressive increase, yellow urine, stool was white pottery earth tones. SCT prompted expansion of intrahepatic bile ducts. Laboratory TBIL214.3pmol / L, DBIL112.3pmol / L, GGT365U / L, ALP452U / L, WBC16 × 109 个 / L. PTCD Intraoperative angiography showed stenosis of common bile duct was cut kind of intraoperative drainage of bile was dark brown, intraoperative biopsy. Pathological results suggest that bile duct adenocarcinoma. Preoperative and postoperative symptoms of high dose of antibiotics to fight infections, 1 week after bile culture + sensitivity test indicated that fungal infection. Application Diflucan symptoms improved after treatment. Refers to the intestinal fluid reflux, the bile is no bacterial growth, the presence of bile, poor drainage, poor physical fitness or the patient may lead to a bacterial infection. Pathogenic bacteria in biliary tract infection with gram-negative bacteria in the main, including Escherichia coli,You are not allowed to view links. Register or Login, Klebsiella and Enterobacter spp enteritis. A small number of Gram-positive bacteria Enterococcus infections ..., Enterococcus infection on the rise in recent years, even accounting for bacterial infection in the third. Ampicillin is generally used in medicine, Pioneer V, a serious infection can use ceftazidime. If, as a result of poor bile drainage causes mild infections, bile can be automatically restored after the resumption of patency, the general application of antibiotics is not necessary. Patients with weak constitutions, cachexia in advanced cancer or chronic wasting disease state,You are not allowed to view links. Register or Login, the combined poor bile drainage, biliary fungal infections can occur, such as long-term inappropriate use of antibiotics, and even can lead to infection. Case 1 cholangiocarcinoma liver metastasis, accompanied by liver injury, TNM stage IVA is a period of poor resistance; Case 2,You are not allowed to view links. Register or Login, a longer duration of jaundice, physical weakness, white blood cell count suggest biliary tract infection, high dose of antibiotics after a long period, biliary tract biopsy, histopathology, fungal strains prompted groups. Application of effective antifungal therapy. The treatment of obstructive jaundice, histopathological type of treatment not only for the right to develop and provide evidence, but also generally indicates that the disease development and prognosis. Technical difficulties in conventional bile duct biopsy, most patients had no pathological findings Huang resistance, treatment blindly. Percutaneous transhepatic biliary drainage (P1 ℃ D) intraoperative biopsy technique developed and convenient for solving the problem provides a powerful weapon [. 2 2 in the liver to discuss the case of biliary drainage unobstructed, and even twelve Figure l