Cappell M S
Department of Medicine, UMDNJ-Robert Wood Johnson (formerly Rutgers) Medical School, New Brunswick 08903-0019.
J Clin Gastroenterol. 1994 Jan;18(1):53-6. doi: 10.1097/00004836-199401000-00013.
A 51-year-old man with no history of liver disease had acute severe jaundice, with a serum level of total bilirubin of 27.4 mg/dl and an alkaline phosphatase level of 731 IU/L due to distal common bile duct compression from peripancreatic head fibrosis associated with retroperitoneal fibrous. Other obstructive phenomena in this patient included bilateral hydronephrosis from ureteral fibrosis encasement and testicular swelling from fibrous encasement of vessels draining the scrotum. Autopsy demonstrated massive retroperitoneal fibrosis, with angulation and compression of the distal common bile duct by fibrosis covering the head of the pancreas. The intrahepatic biliary tree was dilated because of the distal choledochal obstruction, but the proximal common bile duct was not dilated due to mural fibrosis.
一名无肝脏疾病史的51岁男性出现急性严重黄疸，血清总胆红素水平为27.4mg/dl，碱性磷酸酶水平为731IU/L，原因是胰头周围纤维化伴腹膜后纤维化导致胆总管远端受压。该患者的其他梗阻现象包括输尿管纤维化包裹引起的双侧肾积水以及阴囊引流血管纤维化包裹引起的睾丸肿大。尸检显示大量腹膜后纤维化，覆盖胰腺头部的纤维化使胆总管远端成角并受压。由于胆总管远端梗阻，肝内胆管树扩张，但由于管壁纤维化，胆总管近端未扩张。
