Kim Bong Gap, Kang Dae Hwan, Choi Cheol Woong, Kim Hyung Wook, Lee Jae Hyung, Kim Suk Hun, Yeo Hye Ju, Lee Soo Yong
Department of Internal Medicine, Pusan National University College of Medicine, Yangsan, Korea.
Clin Endosc. 2011 Sep;44(1):55-8. doi: 10.5946/ce.2011.44.1.55. Epub 2011 Sep 30.
Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
胆管狭窄可由多种疾病引起。肝内胆管（IHD）狭窄通常与肝内胆管结石及胆管炎有关。然而，无肝内胆管结石的局灶性肝内胆管狭窄常引发诊断难题。诸如华支睾吸虫病等寄生虫病可能是肝内胆管狭窄的罕见病因。人类华支睾吸虫病（华支睾吸虫感染）是包括韩国在内的东亚地区的一种地方性寄生虫病，患者因食用生鱼而感染。在影像学检查中，华支睾吸虫病通常表现为肝内小胆管弥漫性、轻微或轻度扩张，尤其是在周边部位，肝外胆管无扩张。然而，当影像学改变不典型时，华支睾吸虫病的诊断有时会很困难。我们报告一例由华支睾吸虫病引起的局灶性左肝内胆管扩张病例，该病例曾被误诊为恶性肿瘤。
