Kroemer A, Sabet-Baktach M, Doenecke A, Ruemmele P, Scherer M N, Schlitt H J, Breidert M
Department of Surgery, University Hospital Regensburg.
Z Gastroenterol. 2012 Aug;50(8):766-70. doi: 10.1055/s-0031-1299110. Epub 2012 Aug 15.
Eosinophilic cholangitis is a rare clinical entity characterised by transmural eosinophilic infiltration of the biliary system. The aetiology of this disease is still unclear. We report on a 49-year-old male patient who presented with symptoms of obstructive jaundice and imaging suggestive for periampullary carcinoma. After partial pancreatoduodenectomy for suspected pancreatic cancer, pathology revealed massive eosinophilic cholecystitis as well as intra- and extrahepatic eosinophilic cholangitis with pseudopolypoid papillary lesions. Our case illustrates the diagnostic pitfalls in eosinophilic cholangitis as careful imaging procedures - optimally interdisciplinary - should be considered and performed in such patients. In conclusion, eosinophilic cholangitis is an uncommon, inflammatory condition that needs to be considered as a differential diagnosis for periampullary malignancies.
嗜酸性胆管炎是一种罕见的临床病症，其特征为胆管系统的透壁嗜酸性粒细胞浸润。该疾病的病因仍不清楚。我们报告一例49岁男性患者，其表现为梗阻性黄疸症状，影像学检查提示壶腹周围癌。在因疑似胰腺癌行部分胰十二指肠切除术后，病理显示为大量嗜酸性胆囊炎以及肝内和肝外嗜酸性胆管炎伴假息肉样乳头状病变。我们的病例说明了嗜酸性胆管炎的诊断陷阱，因为对于此类患者应考虑并进行仔细的影像学检查——最好是多学科联合检查。总之，嗜酸性胆管炎是一种罕见的炎症性疾病，需要作为壶腹周围恶性肿瘤的鉴别诊断加以考虑。
