Sobesky R, Chollet J M, Prat F, Karkouche B, Pelletier G, Fritsch J, Choury A D, Allonier C, Bedossa P, Buffet C
Dept. of Hepatogastroenterology, Bicêtre Hospital, Paris, France.
Endoscopy. 2003 Aug;35(8):698-700. doi: 10.1055/s-2003-41522.
An exceptional cause of obstructive jaundice is reported in the present case. A 51-year-old woman progressively developed jaundice with pruritus, and abdominal ultrasonography revealed dilated intra- and extrahepatic bile ducts. Endoscopic retrograde cholangiography and endoscopic ultrasonography showed a tumor in the distal common bile duct, but failed to determine the nature of the lesion, and the patient underwent a pancreaticoduodenectomy. The final diagnosis was an inflammatory pseudotumor of the common bile duct. Inflammatory pseudotumors are uncommon, without evident pathogenesis, and are described in many organs. The localization in the common bile duct is exceptional. The prognosis is good, and a more conservative approach is possible if the diagnosis is certain before surgery.
本病例报告了一例梗阻性黄疸的罕见病因。一名51岁女性逐渐出现黄疸伴瘙痒,腹部超声显示肝内和肝外胆管扩张。内镜逆行胰胆管造影和内镜超声检查显示胆总管远端有肿瘤,但未能确定病变性质,患者接受了胰十二指肠切除术。最终诊断为胆总管炎性假瘤。炎性假瘤并不常见,发病机制不明,在许多器官中均有描述。其在胆总管的定位较为罕见。预后良好,如果在手术前确诊,则可能采取更保守的治疗方法。