Gastrointestinal System Disorders Q 189 - Gyan Darpan : Learning Portal
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Wednesday, 13 April 2022

Gastrointestinal System Disorders Q 189

The hospital administrator had undergone percutaneous transhepatic cholangiography. Which assessment finding indicates complication after the operation?
    A. Fever and chills
    B. Hypertension
    C. Bradycardia
    D. Nausea and diarrhea

Correct Answer: A. Fever and chills

Septicemia is a common complication after a percutaneous transhepatic cholangiography. Evidence of fever and chills, possibly indicative of septicemia, is important. Although PTC may be performed to treat the obstruction that is the cause of sepsis, PTC itself may also cause sepsis. Antibiotics, IV fluids, oxygen, and vasopressors in the setting of an intensive care unit should be considered.

Option B: Hypotension, not hypertension, is associated with septicemia. The Society of Interventional Radiology (SIR) has published complication rates for PTC and PBD. The rate of major complications is around 2% to 10%. Major complications include inducing sepsis, other severe infections (such as an abscess), bile leak/biloma, hemorrhage (subcapsular hematoma, pseudoaneurysm), pneumothorax, and death.
Option C: Tachycardia, not bradycardia, is most likely to occur. Transgression of blood vessels during PTC is to be expected. Coagulation usually occurs successfully, and hemorrhage ceases entirely within 2 to 3 days. Bleeding through the catheter can occur if a catheter side hole is left in communication with a hepatic vessel or if a pseudoaneurysm develops.
Option D: Nausea and diarrhea may occur but are not classic signs of sepsis. If electrolyte depletion occurs due to high-output external drainage, then the electrolytes should be replaced and considerations should be made on converting the catheter to internal drainage as soon as possible.

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