孕期肝功能检查异常：产后随访的重要性。
Deranged liver function tests in pregnancy: the importance of postnatal follow-up.
作者信息
Stone Sophia, Girling Joanna C
机构信息
Department of Obstetrics and Gynaecology , St Mary's Hospital , Portsmouth PO3 6AD , UK.
Department of Obstetrics and Gynaecology , West Middlesex University Hospital , Twickenham Road, Isleworth, Middlesex TW7 6AF, London , UK.
出版信息
Obstet Med. 2009 Mar;2(1):32-3. doi: 10.1258/om.2008.080036. Epub 2009 Mar 1.
Abstract
We report an asymptomatic 40-year-old woman with persistently deranged liver function tests found incidentally in the first trimester of her second pregnancy. No cause was apparent clinically, serologically or with imaging studies until a new finding of hepatomegaly led to a repeat ultrasound scan six weeks following delivery. A mass in the region of the common hepatic duct was confirmed to be a cholangiocarcinoma, with vascular invasion precluding curative surgical resection. This case highlights the need for close vigilance of patients with unexplained and persistently abnormal liver function tests, antenatally and postdelivery.
摘要
我们报告了一名40岁无症状女性，在其第二次怀孕的孕早期偶然发现肝功能检查持续异常。临床、血清学及影像学检查均未发现明显病因，直至产后六周肝脏肿大这一新发现导致再次进行超声扫描。肝总管区域的肿物被确诊为胆管癌，伴有血管侵犯，无法进行根治性手术切除。该病例凸显了对产前及产后肝功能检查原因不明且持续异常的患者进行密切监测的必要性。
相似文献
1
Deranged liver function tests in pregnancy: the importance of postnatal follow-up.孕期肝功能检查异常：产后随访的重要性。
Obstet Med. 2009 Mar;2(1):32-3. doi: 10.1258/om.2008.080036. Epub 2009 Mar 1.
2
First Reported Case of Primary Intrahepatic Cholangiocarcinoma with Pure Squamous Cell Histology: A Case Report.首例纯鳞状细胞组织学的原发性肝内胆管癌病例报告：病例报告
Am J Case Rep. 2015 Jul 9;16:438-44. doi: 10.12659/AJCR.894609.
3
Right trisectionectomy with principle en bloc portal vein resection for right-sided hilar cholangiocarcinoma: no-touch technique.右三叶切除术联合整块门静脉切除治疗右肝门部胆管癌：无接触技术。
Ann Surg Oncol. 2012 Apr;19(4):1324-5. doi: 10.1245/s10434-011-2072-x. Epub 2011 Oct 15.
4
Hepatobiliary complications of oral contraceptives.口服避孕药的肝胆并发症。
J Gen Intern Med. 1992 Mar-Apr;7(2):199-209. doi: 10.1007/BF02598014.
5
Spontaneous rupture of intrahepatic bile duct following portal vein embolization in a patient with perihilar cholangiocarcinoma: a case of successful curative resection.肝门部胆管癌患者门静脉栓塞后肝内胆管自发性破裂：1例成功根治性切除病例
Korean J Hepatobiliary Pancreat Surg. 2013 Feb;17(1):42-7. doi: 10.14701/kjhbps.2013.17.1.42. Epub 2013 Feb 28.
6
Fulminant hepatitis A infection in second trimester of pregnancy requiring living-donor liver transplantation.妊娠中期暴发性甲型肝炎感染需活体供肝肝移植。
J Obstet Gynaecol Res. 2012 Apr;38(4):745-8. doi: 10.1111/j.1447-0756.2011.01757.x. Epub 2012 Mar 2.
7
Prospective evaluation of abnormal liver function tests in pregnancy.孕期肝功能检查异常的前瞻性评估
Trop Gastroenterol. 2005 Oct-Dec;26(4):188-93.
8
Obstetrical complications associated with abnormal maternal serum markers analytes.与母体血清标志物分析物异常相关的产科并发症。
J Obstet Gynaecol Can. 2008 Oct;30(10):918-932. doi: 10.1016/S1701-2163(16)32973-5.
9
Acute fatty liver in the second trimester of pregnancy.妊娠中期急性脂肪肝
Prim Care Update Ob Gyns. 1998 Jul 1;5(4):191. doi: 10.1016/s1068-607x(98)00116-4.
10
[Case of papillary cholangiocarcinoma with curative resection after long-term follow-up].
Nihon Shokakibyo Gakkai Zasshi. 2019;116(1):88-98. doi: 10.11405/nisshoshi.116.88.
引用本文的文献
1
Postpartum related intrahepatic cholangiocarcinoma with fusion and severe hyperbilirubinemia with response to FGFR inhibitor pemigatinib: case report and review.产后相关的肝内胆管癌伴融合及严重高胆红素血症且对FGFR抑制剂培米替尼有反应：病例报告及文献复习
J Gastrointest Oncol. 2023 Dec 31;14(6):2627-2636. doi: 10.21037/jgo-23-693. Epub 2023 Dec 12.
2
Recurrent Cholangiocarcinoma in Pregnancy: A Case Report.妊娠期复发性胆管癌：一例报告
AJP Rep. 2018 Oct;8(4):e261-e263. doi: 10.1055/s-0038-1675376. Epub 2018 Nov 12.
3
Jaundice in pregnancy.妊娠期黄疸
Obstet Med. 2009 Dec;2(4):174. doi: 10.1258/om.2009.090048. Epub 2009 Nov 30.
4
Gallbladder carcinoma in a pregnant patient with Crohn's disease complicated with gallbladder involvement.妊娠期合并胆囊病变的克罗恩病患者并发胆囊癌。
World J Gastrointest Oncol. 2013 Feb 15;5(2):29-33. doi: 10.4251/wjgo.v5.i2.29.
本文引用的文献
1
Unusual cause of itching in a pregnancy (cholangiocarcinoma).孕期瘙痒的罕见病因（胆管癌）。
J Obstet Gynaecol. 2008 Feb;28(2):230-1. doi: 10.1080/01443610801916296.
2
Cholangiocarcinoma: natural history, treatment, and strategies for surveillance in high-risk patients.胆管癌：高危患者的自然病程、治疗及监测策略
J Clin Gastroenterol. 2008 Feb;42(2):178-90. doi: 10.1097/MCG.0b013e31806daf89.
3
Estrogens and insulin-like growth factor 1 modulate neoplastic cell growth in human cholangiocarcinoma.雌激素和胰岛素样生长因子1调节人胆管癌中的肿瘤细胞生长。
Am J Pathol. 2006 Sep;169(3):877-88. doi: 10.2353/ajpath.2006.050464.
4
Estrogens and the pathophysiology of the biliary tree.雌激素与胆道树的病理生理学
World J Gastroenterol. 2006 Jun 14;12(22):3537-45. doi: 10.3748/wjg.v12.i22.3537.
5
Prospective study of liver dysfunction in pregnancy in Southwest Wales.威尔士西南部妊娠期肝功能障碍的前瞻性研究。
Gut. 2002 Dec;51(6):876-80. doi: 10.1136/gut.51.6.876.
6
Prognostic factors of intrahepatic cholangiocarcinoma after hepatic resection: univariate and multivariate analysis.肝切除术后肝内胆管癌的预后因素：单因素和多因素分析
Hepatogastroenterology. 2002 Mar-Apr;49(44):311-6.
7
Intrahepatic cholangiocarcinoma masquerading as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) in pregnancy: case report.
Am J Obstet Gynecol. 1998 Sep;179(3 Pt 1):823-4. doi: 10.1016/s0002-9378(98)70093-6.
8
Maternal and perinatal outcome in severe pregnancy-related liver disease.重度妊娠相关肝病的母婴及围产期结局
Hepatology. 1997 Nov;26(5):1258-62. doi: 10.1002/hep.510260525.
9
Pregnancy complicated by extrahepatic biliary tract carcinoma. A case report.妊娠合并肝外胆管癌。病例报告。
J Reprod Med. 1983 Feb;28(2):153-5.
10
The risk of liver neoplasia in relation to combined oral contraceptive use.与联合使用口服避孕药相关的肝脏肿瘤风险。
Contraception. 1991 Jun;43(6):643-52. doi: 10.1016/0010-7824(91)90007-3.
Zotero 插件