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JKM > Volume 43(3); 2022 > Article
Lee, Park, Cho, Son, and Lee: A case report of gastrointestinal perforation in patient after biliary stent insertion and the overview of gastrointestinal perforation

Abstract

Objectives

This study aimed to emphasize the importance of accurate and timely diagnosis of acute abdominal pain with simple radiography by reporting a case of gastrointestinal perforation.

Methods

We closely observed the diagnosis and progress of acute abdominal pain after biliary stent and reviewed the outline of gastrointestinal perforation.

Results

Patient diagnosed with urethral cancer metastasis to lung and peritoneum was treated with complex Korean medicinal treatments to deal with anorexia, abdominal pain, jaundice and oliguria. During hospitalization, the patient’s acute abdominal pain after biliary stent was diagnosed with gastrointestinal perforation by using plain chest and abdominal radiography.

Conclusion

Using simple radiography to find out the emergency diseases such as perforation in acute abdominal pain is important clinically.

Fig. 1
Computed Tomography(CT) at diagnosis (2019.02.21.) A: Abdomen CT, B: Chest CT
jkm-43-3-195f1.gif
Fig. 2
Summary of treatment course.
jkm-43-3-195f2.gif
Fig. 3
Changes of LFT and bilirubin after PTBD
jkm-43-3-195f3.gif
Fig. 4
Changes of vital sign and patient’s progress
jkm-43-3-195f4.gif
Fig. 5
Simple X-rays when diagnosed with perforation (2019.03.29)
A: Chest X-ray B: Abdomen S/E
jkm-43-3-195f5.gif
Table 1
Biochemical data of the patient
Parameter 2019-03-11 2019-03-15 2019-03-28
AST(IU/L) 158 162 60
ALT(IU/L) 69 80 22
ALP(IU/L) 279 292 164
Total bilirubin(mg/dL) 3.65 5.71 2.57
Direct bilirubin(mg/dL) 2.8 4.7 1.8
Table 2
Changes of vital sign during administration period
Parameter Blood pressure Pulse rate Body temperature
03-28 02:00 120/70 90 37.1
03-28 06:00 120/70 63 37.1
03-28 10:00 120/70 82 37
03-28 14:00 120/70 86 36.5
03-28 18:00 120/80 76 36.7
03-28 21:00 130/70 90 36.5
03-29 02:00 140/80 84 36.9
03-29 06:00 130/80 91 36.9
03-29 10:00 120/80 96 37

03-29 14:00 130/80 105 36.4

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