Sheen-Chen Shyr-Ming, Sun Cheuk-Kwan, Liu Yei-Wei, Eng Hock-Liew, Ko Sheung-Fat, Kuo Chung-Huang
Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan.
Dig Dis Sci. 2007 Nov;52(11):3140-2. doi: 10.1007/s10620-006-9164-7. Epub 2007 Apr 3.
A 68-year-old women was admitted with the chief complaints of epigastralgia with radiation to the back and jaundice. Fever and chills were also noted. The laboratory data showed alkaline phosphatase, 245 U/L (normal range: 28-94); Direct Bilirubin, 5.29 mg% (0-0.4); Total Bilirubin, 8.4 mg% (0.2-1.4). Surprisingly, the serum CA19-9 was 5673.8 U/ml (normal value: <37). Abdominal sonography showed dilated common hepatic duct. MRCP demonstrated diffuse biliary tree dilatation with a very low signal intensity in distal common bile duct. Surgical intervention reveled a black stone at distal common bile duct and was successfully retrieved. After operation, the CA19-9 fell to 63.1 u/ml two weeks later and returned to normal (10.4 U/ml) one month later.
一名68岁女性因上腹部疼痛并向后背部放射以及黄疸为主诉入院。还注意到有发热和寒战。实验室检查数据显示：碱性磷酸酶245 U/L（正常范围：28 - 94）；直接胆红素5.29 mg%（0 - 0.4）；总胆红素8.4 mg%（0.2 - 1.4）。令人惊讶的是，血清CA19 - 9为5673.8 U/ml（正常值：<37）。腹部超声显示肝总管扩张。磁共振胰胆管造影（MRCP）显示胆管树弥漫性扩张，胆总管远端信号强度极低。手术干预发现胆总管远端有一颗黑色结石，并成功取出。术后，CA19 - 9在两周后降至63.1 u/ml，一个月后恢复正常（10.4 U/ml）。
