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[晚期酒精性肝硬化中肝门周囊肿迅速增大导致梗阻性黄疸的解剖学病例]

[An anatomical case of obstructive jaundice due to the rapid enlargement of hepatic peribiliary cysts in end-stage alcoholic liver cirrhosis].

作者信息

Yoshimura Chisato, Murata Jun, Yamauchi Amane, Sunaga Koji, Kato Mina, Takigawa Atsuo, Nawa Takatoshi, Akamatsu Haruki, Kobayashi Ichizo, Tsujii Masahiko

机构信息

Department of Gastroenterology, Higashiosaka City Medical Center.

Department of Gastroenterology, Ikeda City Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2023;120(11):927-934. doi: 10.11405/nisshoshi.120.927.

Abstract

A man in his 60s had end-stage alcoholic cirrhosis. About six months before his death, hepatic peribiliary cysts (HPBC) rapidly increased, and he developed jaundice and liver failure. The pathological autopsy performed after his death revealed that his intrahepatic bile duct was pressured due to multiple cysts caused by HPBC, which resulted in liver failure. Some cases of HPBC have been associated with alcoholic cirrhosis;however, no other cases of increased HPBC in a short period of time have been reported. Although identifying the cause of increased HPBC in a short time is difficult in this case, it may be have been caused by continuous alcohol drinking after the onset of HPBC. Most patients with HPBC have liver cirrhosis and obstructive jaundice that may promote liver failure as in this case. Therefore, patients with HPBC should not only be instructed for abstinence but also promptly consider effective treatments in the event of obstructive jaundice to prevent liver dysfunction.

摘要

一名60多岁的男性患有终末期酒精性肝硬化。在他去世前约六个月,肝内胆管周围囊肿(HPBC)迅速增多,并且他出现了黄疸和肝功能衰竭。他死后进行的病理尸检显示,其肝内胆管因HPBC导致的多个囊肿而受压,进而导致肝功能衰竭。部分HPBC病例与酒精性肝硬化有关;然而,尚未有其他短期内HPBC增多的病例报道。尽管在该病例中短期内确定HPBC增多的原因很困难,但可能是HPBC发病后持续饮酒所致。大多数HPBC患者患有肝硬化和梗阻性黄疸,这可能像该病例一样促进肝功能衰竭。因此,对于HPBC患者,不仅应指导其戒酒,而且在出现梗阻性黄疸时应及时考虑有效的治疗措施以预防肝功能障碍。

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