Shimizu Shuya, Naitoh Itaru, Nakazawa Takahiro, Hayashi Kazuki, Miyabe Katsuyuki, Kondo Hiromu, Nishi Yuji, Yoshida Michihiro, Umemura Shuichiro, Hori Yasuki, Kato Akihisa, Ohara Hirotaka, Kuno Toshiya, Takahashi Satoru, Joh Takashi
Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Japan.
Intern Med. 2016;55(12):1575-9. doi: 10.2169/internalmedicine.55.6302. Epub 2016 Jun 15.
We herein report a case of a 56-year-old man with IgG4-related sclerosing cholangitis (IgG4-SC) with no biliary stricture, but with a severely thickened bile duct wall. Contrast-enhanced computed tomography showed diffuse swelling of the pancreas and thickening of the common bile duct (CBD) wall with delayed enhancement. Obvious diffuse wall thickening of the CBD was observed on endoscopic ultrasonography. However, endoscopic retrograde cholangiography showed no biliary stricture in the CBD that had thickened. Although IgG4-SC has been classified by a stenotic lesion on cholangiography, we should be aware of some IgG4-SC cases showing only bile duct wall thickness without any biliary stricture.
我们在此报告一例56岁男性IgG4相关性硬化性胆管炎（IgG4-SC）患者，该患者无胆管狭窄，但胆管壁严重增厚。增强计算机断层扫描显示胰腺弥漫性肿大，胆总管（CBD）壁增厚，强化延迟。内镜超声检查发现CBD明显弥漫性壁增厚。然而，内镜逆行胆管造影显示增厚的CBD无胆管狭窄。尽管IgG4-SC已根据胆管造影上的狭窄病变进行分类，但我们应注意一些IgG4-SC病例仅表现为胆管壁增厚而无任何胆管狭窄。
