以急性胰腺炎和梗阻性黄疸为首发表现的肝细胞癌：病例报告
Acute pancreatitis and obstructive jaundice as initial complaints of hepatocellular carcinoma: case report.
作者信息
Jiang Guo-Qing, Qian Jian-Jun, Yao Jie, Jin Sheng-Jie, Bai Dou-Sheng
机构信息
Department of Hepatobiliary Surgery, Clinical Medical College of Yangzhou University, 98 West Nantong Road, Yangzhou 225000, Jiangsu Province, China.
出版信息
World J Surg Oncol. 2014 Jan 14;12:13. doi: 10.1186/1477-7819-12-13.
BACKGROUND
Patients with cirrhosis-associated hepatocellular carcinoma (HCC) rarely present with acute pancreatitis (AP) and obstructive jaundice as the main clinical features. AP with obstructive jaundice caused by common bile duct embolism (CBDE) is very rare.
CASE PRESENTATION
A 54-year-old man with CBDE was misdiagnosed with common bile duct stones three times over a 7-month period. Investigations during this time did not identify CBDE. Surgical exploration was performed because of AP, obstructive jaundice, and a tumor in the left lobe of the liver. CBDE from the hepatic tumor was diagnosed by intraoperative biopsy and frozen section examination. The patient underwent left hemihepatectomy, cholecystectomy, and bile duct exploration.
CONCLUSION
Preoperative diagnosis of CBDE is difficult because of the rarity of the condition, lack of physician awareness, and easy misdiagnosis on imaging examinations. Early and accurate diagnosis of this condition is important.
背景
肝硬化相关肝细胞癌（HCC）患者很少以急性胰腺炎（AP）和梗阻性黄疸为主要临床特征。由胆总管栓塞（CBDE）引起的伴有梗阻性黄疸的AP非常罕见。
病例介绍
一名患有CBDE的54岁男性在7个月内被误诊为胆总管结石3次。在此期间的检查未发现CBDE。由于AP、梗阻性黄疸和肝左叶肿瘤而进行了手术探查。术中活检和冰冻切片检查诊断为肝肿瘤引起的CBDE。患者接受了左半肝切除术、胆囊切除术和胆管探查术。
结论
由于CBDE这种情况罕见、医生认识不足以及影像学检查容易误诊，术前诊断困难。对这种情况进行早期准确诊断很重要。
Zotero 插件