Ohge H, Takesue Y, Yokoyama T, Hiyama E, Murakami Y, Imamura Y, Shimamoto F, Matsuura Y
First Department of Surgery, Faculty of Medicine, Hiroshima University, Japan.
J Gastroenterol. 2000;35(11):870-2. doi: 10.1007/s005350070026.
We report a case of progression of primary biliary cirrhosis (PBC) after proctocolectomy for ulcerative colitis. A 43-year-old woman underwent a total proctocolectomy after being diagnosed with ulcerative colitis. In the course of the preoperative investigation, liver function test results were within the normal range. Four months after the proctocolectomy, the patient showed a high level of alkaline phosphatase (2398 IU/l) and a positive anti-mitochondrial antibody titer (>1:160). There were no associated symptoms. A liver biopsy demonstrated expansion of all portal areas by infiltrates of lymphocytes and histiocytes. These appearances indicated chronic biliary disease and were compatible with PBC. The association of PBC and ulcerative colitis is rare. However, a review of the recent literature suggests that PBC and ulcerative colitis may be associated; this combination should be kept in mind.
我们报告一例溃疡性结肠炎患者在直肠结肠切除术后原发性胆汁性肝硬化（PBC）病情进展的病例。一名43岁女性在被诊断为溃疡性结肠炎后接受了全直肠结肠切除术。术前检查过程中，肝功能测试结果在正常范围内。直肠结肠切除术后四个月，患者碱性磷酸酶水平较高（2398 IU/l），抗线粒体抗体滴度呈阳性（>1:160）。无相关症状。肝脏活检显示所有门静脉区域因淋巴细胞和组织细胞浸润而扩大。这些表现提示慢性胆道疾病，与PBC相符。PBC与溃疡性结肠炎的关联罕见。然而，近期文献综述表明PBC与溃疡性结肠炎可能有关联；应牢记这种组合情况。
