胆红素钙淤泥导致先天性胆管扩张症的早期发病：两例报告
Calcium bilirubinate sludge causes early onset of congenital biliary dilatation: a report of two cases.
作者信息
Kato Shoko, Kaneko Kenitiro, Matsushita Nozomi, Kurahashi Shintaro, Osawa Takaaki, Matsumura Tatsuki, Saito Takuya, Fukami Yasuyuki, Komatsu Shunichiro, Sano Tsuyoshi
机构信息
Department of Surgery, Aichi Medical University, 1-1 Yazakokarimata, Ngakute, Aichi, 480-1195, Japan.
出版信息
Surg Case Rep. 2021 Apr 13;7(1):92. doi: 10.1186/s40792-021-01175-x.
BACKGROUND
Symptomatic congenital biliary dilatation (CBD) during early infancy is always characterized by cystic dilation of the common bile duct with a narrow segment connecting the pancreatic duct.
CASE PRESENTATION
In two consecutive infants with a prenatal diagnosis of CBD, we found that biliary sludge had formed in the cyst upon the appearance of symptoms including acholic stool and hypertransaminasemia. Infrared absorption spectrometry revealed that the sludge consisted of calcium bilirubinate.
CONCLUSION
We suggest that overproduction of bilirubin by neonatal hemolysis causes sedimentation of bilirubin calcium, resulting in obstruction of the narrow segment and development of symptoms.
背景
婴儿早期有症状的先天性胆管扩张（CBD）总是以胆总管的囊性扩张为特征，且有一个狭窄段连接胰管。
病例报告
在连续两名产前诊断为CBD的婴儿中，我们发现，在出现无胆汁粪便和高转氨酶血症等症状时，囊肿内已形成胆泥。红外吸收光谱显示，胆泥由胆红素钙组成。
结论
我们认为，新生儿溶血导致胆红素过度生成，引起胆红素钙沉淀，导致狭窄段梗阻并出现症状。
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