Pregnant women with acute pancreatitis were successfully treated by endoscopic technique
It is reported that acute pancreatitis is one of clinical acute abdomen, often the onset of acute, rapid progress, not timely treatment is easy to develop into severe and threaten the life of patients. If acute pancreatitis occurs during pregnancy, it will greatly increase the risk of disease and the difficulty of treatment, and the disease will bring great threat to the mother and the fetus. For acute pancreatitis caused by gallstones, duodenoscopic bile duct drainage (ERCP) is the most minimally invasive and effective treatment. However, ERCP requires X-ray guidance, which may bring risks of teratogenesis and even abortion for pregnant patients, so it has become one of the difficulties in clinical management.
The discharged patient, Ms. Chen, 40 years old, had a 36-week intrauterine pregnancy and a 7-8 year history of gallstones. She went to another hospital because of "upper abdominal pain with skin and sclera yellow staining for 4 days". After complete examination, B-ultrasound showed dilatation of bile duct and multiple gallbladder stones. Biochemical examination showed total bilirubin 89.8umol/L (normal value)
Liu Chun, the attending physician of biliary and pancreatic surgery, received Ms. Chen and reported the case to Liu Wei, the director of the department, and contacted the obstetric consultation to evaluate the fetus. After discussion, combined with Ms. Chen's history of cholecystolithiasis and various examination results, it was considered that the cholecystolithiasis discharged into the common bile duct, causing bile duct obstruction and leading to acute biliary pancreatitis. Considering the special circumstances of the patient's pregnancy, the team decided to perform an immediate radiation-free ERCP on her based on previous experience.
