ERCP Sonrası Bakteriyemi ile Mortal Seyreden Klatskin Tümörü Olgusu
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Date
2015
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Abstract
Klatskin tümörleri yada hiler kolanjiokarsinoma erken dönemde semptom vermemesi nedeniyle geç tanı almaktadır. Uzun dönem yaşam beklentisi oldukça düşüktür. Daha önceden obesite ve depresyon tanısı olan 83 yaşındaki bayan hasta, iki gün önce başlayan karın ağrısı, bulantı, sarılık şikâyetleriyle Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği polikliniğine başvurdu. Hastanın Aile Hekimliği Polikliniğinde yapılan hepatobiliyer ultrasonografi incelenmesinde safra kesesi çapı 50 mm, koledok 14 mm ile distandü görülmüştür. Hasta Klinik-laboratuvar bulgularıyla Enfeksiyon Hastalıkları ve Gastroenteroloji Polikliniklerinde değerlendirildi. Endoskopik Retrograd Kolanjiografi (ERCP) yapılması için dış merkeze yönlendirildi. ERCP sonrası klinik durumu daha da ağırlaştıran bakteriyemi gelişmiştir. Bu olguda, klatskin tümörlü yaşlı hastada invazif tıbbi girişim üzerine eklenmiş bakteriyemik enfeksiyon tablosunun prognozu kötüleştirip mortaliteyi artırdığı irdelenmiştir.
Due to the late onset of symptoms, Klatskin tumors or hilar cholangiocarcinoma are usually diagnosed late and long-term life expectancy is very low. In this case, an 83-year-old female patient with diagnosis of obesity and depression was admitted to Family Medicine Outpatient Clinic in Duzce University Medical Faculty because of abdominal pain and nausea ongoing for two days. In hepatobiliary ultrasound examination made in Family Medicine Clinic, gallbladder diameter was 50 mm and bile duct was seen distended to 14 mm. With these findings the patient was assessed by Infectious Diseases and Gastroenterology Clinic. She was directed outside the province for an endoscopic retrograde cholangiopancreatography (ERCP). After ERCP clinical situation is further aggravated by developed bacteremia. Due to the late onset of symptoms of the disease, as in our case, and developing bacteremic infections, the disease has resulted in a rapid mortality. In this case, it has been evaluated that table of bacteremic infection superimposed invasive medical procedures resulted to severe prognosis and increases the mortality in elderly patient with Klatskin tumor
Due to the late onset of symptoms, Klatskin tumors or hilar cholangiocarcinoma are usually diagnosed late and long-term life expectancy is very low. In this case, an 83-year-old female patient with diagnosis of obesity and depression was admitted to Family Medicine Outpatient Clinic in Duzce University Medical Faculty because of abdominal pain and nausea ongoing for two days. In hepatobiliary ultrasound examination made in Family Medicine Clinic, gallbladder diameter was 50 mm and bile duct was seen distended to 14 mm. With these findings the patient was assessed by Infectious Diseases and Gastroenterology Clinic. She was directed outside the province for an endoscopic retrograde cholangiopancreatography (ERCP). After ERCP clinical situation is further aggravated by developed bacteremia. Due to the late onset of symptoms of the disease, as in our case, and developing bacteremic infections, the disease has resulted in a rapid mortality. In this case, it has been evaluated that table of bacteremic infection superimposed invasive medical procedures resulted to severe prognosis and increases the mortality in elderly patient with Klatskin tumor
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Volume
7
Issue
2
