Background: Abdominal ultrasound has proven to be a useful, safe, versatile, with appropriate experience, help earlier diagnosis and
comprehensive management of patients seen in the emergency department.
Objective: we present a case of Jaundice biliary stent obstruction in patients with pancreatic neoplasia., through the use of US scanning used by Emergency Phisicians.
Patients and Methods: We report the case of a patient of 64 years with hypertension, diabetes mellitus, and pancreatic neoplasia bearer of 8 French plastic stent by ERCP for biliary drainage for 6 days as palliative treatment, go to the hospital for abdominal pain in epigastrium and jaundice than 48 hours earlier. No fever, vomiting, diarrhea, or other associated symptoms, although marked anorexia.
Results: On examination, jaundice universal, no other significant data. The analyzes highlighted a creatinine of 1.98 mg / dl, a bilirubin of 9.52 at the expense of direct fraction (8.60 mg / dl), an AST 245, LDH 255, 230 amylase, 22,500 neutrophilic leukocytes. The abdomen and chest radiology without significant alterations. She underwent an abdominal ultrasound at the bedside where we found an image central hyperechoic endoprosthetic acoustic shadowing, compatible with gallstones, why was derived for urgent ERCP, sphincterotomy, removal of
prosthesis, washing and placement 10 French prostheses, allowing a favorable evolution of the patient discharged within 72 hours without complications.
Conclusion: The use of stents as temporary drainage of the bile duct as palliative treatment for pancreatic head tumors is an effective, useful, safe and effective, it also represents a decrease in short-term mortality in these patients, and survival increased disease-free. The use of ultrasound in emergency allows us greater agility and speed in the diagnosis of prosthetic obstructions, allowing a more integrated
management of the same.
Bibliography:- Chen VK, Arguedas MR, Baron TH. Expandable metal biliary stents before pancreaticoduodenectomy for pancreatic
cancer: a Monte-Carlo decision analysis. Clin Gastroenterol Hepatol 2005; 3:1229.
