Zeman R, Taylor K J, Burrell M I, Gold J
Radiology. 1980 Mar;134(3):689-92. doi: 10.1148/radiology.134.3.7355219.
This report presents eight patients with dilatation of the biliary tree, six of whom had no clinical or laboratory evidence of biliary tract disease except for elevated levels of serum alkaline phosphatase. In two patients, dilatation was caused by obstruction of only one hepatic duct; in three, it was caused by a pancreatic tumor; and in three, it was associated with gallstones which exercised a ball-valve effect, producing intermittent obstruction. The elevation of the alkaline phosphatase level in six of these patients suggests that it is a more sensitive indicator of biliary tract obstruction than the serum bilirubin level is. The recognition of biliary dilatation in one or both lobes of the liver should lead to a careful examination, with ultrasound or another modality, of the porta hepatis, common bile duct, and pancreas.
本报告介绍了8例肝内胆管扩张患者，其中6例除血清碱性磷酸酶水平升高外，无胆道疾病的临床或实验室证据。2例患者的胆管扩张是由单一肝管梗阻所致；3例是由胰腺肿瘤引起；3例与胆结石有关，胆结石起到球阀作用，造成间歇性梗阻。这些患者中有6例碱性磷酸酶水平升高，这表明它是比血清胆红素水平更敏感的胆道梗阻指标。认识到肝一叶或两叶存在胆管扩张，应采用超声或其他检查手段仔细检查肝门、胆总管和胰腺。
