A rare case: Asymptomatic spontaneous pneumobilia

Abstract

Pneumobilia, or aerobilia, is defined as the presence of gas in the biliary system. It may occur for various reasons, including recent enterobiliary system interventions, sphincter of oddi dysfunction, and enterobiliary fistula and anastomoses. A 61-year-old male patient presented to our emergency department due to nausea and vomiting. He had no history of drug use other than proton pump inhibitor medication, nor of alcohol or substance use. Although no history of previous medical intervention was present, gas (pneumobilia) was detected in the intrahepatic biliary ducts. We suspected that the incidentally detected pneumobilia in this patient, who also suffered from food poisoning, developed spontaneously in association with peptic ulcer and might have derived from a thin, asymptomatic enterobiliary fistula. Depending on its cause, pneumobilia may not require emergency surgery. The possibility of enterobiliary fistula should not be overlooked in patients presenting to the emergency department with chronic peptic ulcer symptoms.

Keywords

• Pneumobilia

Nadir bir olgu: Asemptomatik spontan pnömobilya

Öz

Aerobilia olarak da bilinen pneumobilia, biliyer sistemde gaz olması olarak tanımlanır. Son zamanlarda yapılmış enterobilier sistem girişimleri, Oddi sfinkter disfonksiyonu, enterobilier sistem fistül ve anastomozları gibi değişik nedenlerle gelişebilir.  Altmış bir yaşında erkek hasta bulantı kusma şikayeti ile acil servise başvurdu. Proton pompa inhibitörü ilacı dışında herhangi bir ilaç, alkol veya madde kullanım öyküsü olmayan hastada, daha önce herhangi tıbbi girişim işlemi geçirmemiş olmamasına rağmen intrahepatik safra yollarında gaz (pneumobilia) tespit edildi. Besin zehirlenmesi de olan hastada tesadüfen tespit edilen pneumobilia’nın, peptik ülsere bağlı spontan gelişmiş, asemptomatik enterobilier ince bir fistülden kaynaklanmış olabileceği düşünüldü. Pneumobilia, geliştiği nedene bağlı olarak acil cerrahi girişim gerektirmeyebilir. Kronik peptik ülser şikayetleri ile acil servise müracaat eden hastalarda enterobilier fistül gelişmiş olabileceği gözardı edilmemelidir.

Anahtar Kelimeler

• Pneumobilia,İntrahepatik safra yollarında gaz,Saber işareti,Hepatik portal ven gazı

Kaynakça

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