Mittelstaedt W E, Speranzini M B, Deutsch C R, Cunha J C, Pires P W, de Oliveira M R
Arq Gastroenterol. 1986 Apr-Jun;23(2):76-87.
Congenital cystic dilatation of the intrahepatic biliary ducts, known as Caroli's disease, is rarely recognized in general surgical practice and often overlooked. Until now little more than a hundred cases have been described although modern diagnostic procedures disclose more frequently new ones. Three patients with this anomaly have been treated by the authors during the past years and the different aspects concerning diagnosis and treatment are discussed and compared with existing information. In all three patients colic pain in the upper abdomen was the first symptom reported in the first years of life. In one patient jaundice and fever were associated with the abdominal pain and cholangitis developed a secondary biliary cirrhosis. Somatic underdevelopment, consequence of the cirrhosis in this child was observed. In two patients an intrahepatic hepaticojejunostomy was performed and a left hepatectomy in the third. In the two older children intrahepatic gallstones were found; in the younger one no stones were found inside the dilated ducts.
肝内胆管先天性囊状扩张症,即卡罗里病,在普通外科实践中很少被识别,且常被忽视。尽管现代诊断方法能更频繁地发现新病例,但迄今为止描述的病例不过一百多例。在过去几年中,作者治疗了3例患有这种异常疾病的患者,并对诊断和治疗的不同方面进行了讨论,并与现有资料进行了比较。所有3例患者在生命的最初几年均以上腹部绞痛为首发症状。1例患者的腹痛伴有黄疸和发热,继而发展为胆管炎和继发性胆汁性肝硬化。观察到该患儿因肝硬化导致身体发育不全。2例患者接受了肝内肝管空肠吻合术,第3例接受了左肝切除术。2例年龄较大的儿童发现有肝内胆结石;年龄较小的患儿在扩张的胆管内未发现结石。