胆管内破裂的肝囊肿性病变的处理：一例报告
The management of a cystic hepatic lesion ruptured in the bile ducts: a case report.
作者信息
Baba Hicham, Belhamidi Mohamed Said, El Fahssi Mohammed, El Ghanmi Jihad, Zentar Aziz
机构信息
Department of General Surgery, Mohammed V Teaching Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
Department of Urology, University Hospital of Avicenne, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
出版信息
J Med Case Rep. 2017 Jun 16;11(1):159. doi: 10.1186/s13256-017-1329-9.
BACKGROUND
Hepatic cystadenoma is a rare benign cystic tumor; it tends to recur after incomplete surgical resection and has malignant potential. We report the case of a patient with a ruptured biliary cystadenoma in the common bile duct that caused diagnostic and therapeutic problems.
CASE PRESENTATION
A 34-year-old North African woman, admitted for angiocholitis, was operated 2 months before for a hepatic cystic lesion taken for a hydatid cyst compressing her common bile duct. The clinical and the complementary examinations converged toward recurrence of the hydatid cyst for which a surgical resection was decided. Intraoperative findings as well as the histological study of the "membranes" extracted from her common bile duct indicated a hepatic cystadenoma.
CONCLUSIONS
The rarity of hepatic cystadenoma and the non-specificity of clinical and imaging signs make diagnosis of hepatic cystadenoma difficult, especially when it is complicated by rupture in the bile ducts; this contributes to a delay in diagnosis and an inadequate therapeutic approach.
背景
肝囊腺瘤是一种罕见的良性囊性肿瘤；手术切除不完全时易复发，且有恶变潜能。我们报告一例胆总管胆源性囊腺瘤破裂的患者，该病例导致了诊断和治疗方面的问题。
病例介绍
一名34岁的北非女性因胆管炎入院，2个月前因肝囊性病变接受手术，该病变被诊断为压迫胆总管的包虫囊肿。临床和辅助检查均指向包虫囊肿复发，遂决定进行手术切除。术中发现以及从胆总管取出的“包膜”的组织学研究表明为肝囊腺瘤。
结论
肝囊腺瘤的罕见性以及临床和影像学表现的非特异性使得肝囊腺瘤的诊断困难，尤其是当其合并胆管破裂时；这导致诊断延迟和治疗方法不当。
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