急性化脓性胆管炎迅速进展为继发性硬化性胆管炎，并通过内镜逆行胆管造影进行序贯随访。

Rapid progress of acute suppurative cholangitis to secondary sclerosing cholangitis sequentially followed-up by endoscopic retrograde cholangiography.

作者信息

Tanaka Y, Koshiyama H, Nakao K, Makita Y, Kobayashi Y, Yoshida Y, Kimura M, Adachi Y

机构信息

Dept. of Internal Medicine, Yokkaichi Social Insurance Hospital, Japan.

出版信息

Endoscopy. 2001 Jul;33(7):633-5. doi: 10.1055/s-2001-15325.

DOI:10.1055/s-2001-15325

PMID:11473338

Abstract

A 66-year-old man was admitted to our hospital because of right hypochondralgia and fever after colonic polypectomy. Endoscopic examination revealed purulent bile excretion from the duodenal papilla orifice; based on this finding, acute suppurative cholangitis was diagnosed. An endoscopic retrograde cholangiography revealed no abnormality in the biliary tree. However, chronic cholestasis persisted, and endoscopic cholangiography performed 4 months later disclosed a beaded appearance of the intrahepatic bile ducts; this sign is a characteristic finding of sclerosing cholangitis. This is the first report of rapid progression of acute suppurative cholangitis to secondary sclerosing cholangitis sequentially followed-up by endoscopic retrograde cholangiography.

摘要

一名66岁男性因结肠息肉切除术后出现右季肋部疼痛和发热而入住我院。内镜检查发现十二指肠乳头开口有脓性胆汁排出；基于这一发现，诊断为急性化脓性胆管炎。内镜逆行胆管造影显示胆道系统无异常。然而，慢性胆汁淤积持续存在，4个月后进行的内镜胆管造影显示肝内胆管呈串珠状；这一征象是硬化性胆管炎的特征性表现。这是首例通过内镜逆行胆管造影序贯随访记录急性化脓性胆管炎快速进展为继发性硬化性胆管炎的报告。