Uchida Yuichiro, Ome Yusuke, Shimata Keita, Nagahisa Yoshio, Okabe Michio, Kawamoto Kazuyuki, Park Tae Bum, Itoh Tadashi, Ogasahara Keizo
Department of General Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
Case Rep Gastroenterol. 2015 Apr 9;9(1):88-92. doi: 10.1159/000381306. eCollection 2015 Jan-Apr.
A 63-year-old woman was admitted because of epigastric pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatography and intraductal ultrasonography revealed a 25-mm papillary nodule in the middle to inferior portion of the common bile duct (CBD). Pancreaticobiliary maljunction (PBM) was also identified. Contrast-enhanced computed tomography also showed an enhanced nodule in the CBD, and we suspected intraductal papillary neoplasm of the bile duct. We performed pylorus-preserving pancreatoduodenectomy. Postoperative pathological examination revealed an inflammatory polyp in the middle CBD. Inflammatory polyp in the bile duct is rare and there are no previous reports accompanied by PBM. PBM is a major risk factor for biliary tract cancer. Preoperative diagnosis of a benign disorder was difficult in this case.
一名63岁女性因上腹部疼痛和梗阻性黄疸入院。内镜逆行胰胆管造影和导管内超声检查显示胆总管中下段有一个25毫米的乳头状结节。同时还发现了胰胆管合流异常(PBM)。增强计算机断层扫描也显示胆总管内有一个强化结节,我们怀疑是胆管内乳头状肿瘤。我们进行了保留幽门的胰十二指肠切除术。术后病理检查显示胆总管中段为炎性息肉。胆管炎性息肉罕见,此前尚无伴有PBM的报道。PBM是胆道癌的主要危险因素。该病例术前难以诊断为良性疾病。