Pushparani P, Redkar R G, Howard E R
Department of Paediatric Surgery, King's College Hospital, London, England.
J Pediatr Surg. 2000 Apr;35(4):649-51. doi: 10.1053/jpsu.2000.0350649.
A female infant who presented with transient obstructive jaundice and who was shown to have mild fusiform dilatation of the common bile duct at the age of 18 months was followed up with hepatobiliary ultrasound scans over a period of 17 years. Enlarging gallbladder polyps were identified during the last 2 years of follow-up, and endoscopic retrograde cholangio-pancreatography (ERCP) showed a common pancreato-biliary channel with minimal bile duct dilatation. A high concentration of pancreatic amylase was detected in the bile. Hepaticojejunostomy and cholecystectomy were performed. Histologically, the resected common bile duct showed fibrous thickening of the wall and loss of surface epithelium. Muscular hypertrophy and polypoid lesions, which were foci of cholesterosis, were identified in the gallbladder. There was a minimal lymphocytic infiltrate in the subepithelial connective tissue. This report documents a progressive change in the ultrasound appearances of the gallbladder and histological changes in the extrahepatic ducts secondary to a common pancreato-biliary channel and pancreato-biliary reflux.
一名曾出现短暂性梗阻性黄疸、18个月大时被发现胆总管有轻度梭形扩张的女婴，接受了为期17年的肝胆超声检查随访。在随访的最后2年中发现胆囊息肉增大，内镜逆行胰胆管造影（ERCP）显示胰胆管共同通道，胆管扩张轻微。胆汁中检测到高浓度的胰淀粉酶。进行了肝空肠吻合术和胆囊切除术。组织学检查显示，切除的胆总管壁呈纤维性增厚，表面上皮缺失。胆囊中发现肌肉肥大和息肉样病变，为胆固醇沉着症病灶。上皮下结缔组织有少量淋巴细胞浸润。本报告记录了继发于胰胆管共同通道和胰胆管反流的胆囊超声表现的渐进性变化以及肝外胆管的组织学变化。
