Terzi Aysen, Kirnap Mahir, Sercan Cigdem, Ozdemir Gokce, Ozdemir Binnaz Handan, Haberal Mehmet
Department of Pathology and Laboratory Medicine, Baskent University, Ankara, Turkey.
Exp Clin Transplant. 2017 Feb;15(Suppl 1):175-177. doi: 10.6002/ect.mesot2016.P52.
Traumatic neuromas of the biliary tract have occasionally been reported to cause strictures at the cystic duct stump as a late complication of cholecystectomy with common bile duct exploration. The incidence of symptomatic traumatic biliary neuroma appears to be low after orthotopic liver transplant, as only 25 patients have been described previously in the English-language literature. Traumatic (amputation) neuroma is a reactive proliferation of pericholangial nerve fibers induced by injury, but it is not a true neoplasm. The diagnosis of traumatic neuroma is possible only by histopathologic examination; the diagnostic finding is a mass of hyperplastic nerve bundles. We report a patient with a traumatic neuroma causing an early biliary stricture with intrahepatic extension after an orthotopic liver transplant. The lesion failed to respond to repeated endoscopic stenting and eventually required hepaticojejunostomy. A biopsy of the liver graft, performed in the 13th month after transplant, showed chronic ductopenic rejection.
据报道，胆囊切除并胆总管探查术后，创伤性胆道神经瘤偶尔会作为晚期并发症导致胆囊管残端狭窄。原位肝移植术后有症状的创伤性胆道神经瘤发生率似乎较低，因为此前英文文献中仅描述过25例患者。创伤性（切断性）神经瘤是由损伤引起的胆管周围神经纤维的反应性增生，但它并非真正的肿瘤。创伤性神经瘤仅通过组织病理学检查才能确诊；诊断依据是增生的神经束团块。我们报告1例原位肝移植术后创伤性神经瘤导致早期胆道狭窄并肝内蔓延的患者。该病变对反复内镜支架置入治疗无效，最终需要行肝空肠吻合术。移植后第13个月对移植肝进行活检，结果显示为慢性胆管减少性排斥反应。
