Yamane Tateki, Uchiyama Kan, Nakamura Makoto, Ishii Takayuki, Kuroda Hiroaki, Hata Daigo, Koido Shigeo, Kato Tomohiro, Fujise Kiyotaka, Tajiri Hisao
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Kashiwa Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2006 Sep;103(9):1067-72.
A 50-year-old man with type B liver cirrohosis was admitted with jaundice and ascites. He had undergone an operation for esophageal variceal rupture at another hospital. Abdominal CT scan and ultrasonography showed cystic dilatation of the extrahepatic portal vein, and Doppler ultrasonography showed it to be a portal vein aneurysm. After admission, jaundice progressed, and not only liver failure but also biliary tract obstruction was suspected as its etiology. Therefore, endoscopic retrograde cholangiography was performed, and it showed a remarkably bent extrahepatic bile duct thought to be caused by extrinsic compression. By combining the finding of endoscopic ultrasonography, we considered that the portal vein aneurysm had displaced the bile duct. We suspected that it also caused cholestasis and cholangitis.
一名50岁的B型肝硬化男性因黄疸和腹水入院。他曾在另一家医院接受过食管静脉曲张破裂手术。腹部CT扫描和超声检查显示肝外门静脉呈囊性扩张,多普勒超声检查显示为门静脉瘤。入院后黄疸加重,病因怀疑不仅有肝衰竭,还有胆道梗阻。因此,进行了内镜逆行胆管造影,结果显示肝外胆管明显弯曲,认为是外部压迫所致。结合内镜超声检查结果,我们认为门静脉瘤使胆管移位。我们怀疑它还导致了胆汁淤积和胆管炎。