González M, Acuña R, Reyes H, Arancibia F, Carvajal C, Donoso S
Departamento de Medicina, Facultad de Medicina, Universidad de Chile (Campus Oriente), Hospital del Salvador, Santiago.
Rev Med Chil. 1993 Jul;121(7):791-4.
Congenital hepatic fibrosis is an autosomic recessive disease, manifested in children or in young adults by hematemesis due to rupture of esophageal varices. Bacterial cholangitis may occur in some patients. Early diagnosis and treatment with portosystemic anastomosis and/or antibiotics may lead to a long survival with a good quality of life. Diagnosis requires histologic confirmation: normal hepatic lobules are surrounded by broad fibrous bands, and an increased number of bile ducts is usually seen in the portal tracts. Liver function remains well preserved. This report consists of 3 patients: a 17-year-old woman, a 10-year-old boy and a 24-year-old woman who developed severe upper GI bleeding due to ruptured esophageal varices. The first two patients were successfully operated on using the Sugiura technique for portal decompression. Their current survival after surgery is 3 and 9 years, respectively, with normal physical examination and liver function tests. The third patient died shortly after admission, due to the concurrence of a severe suppurative cholangitis.
先天性肝纤维化是一种常染色体隐性疾病,在儿童或青年时期表现为因食管静脉曲张破裂导致的呕血。部分患者可能会发生细菌性胆管炎。早期诊断并采用门体分流吻合术和/或抗生素进行治疗,可能会使患者长期存活且生活质量良好。诊断需要组织学证实:正常肝小叶被宽阔的纤维带包围,门静脉区域通常可见胆管数量增多。肝功能保持良好。本报告包含3例患者:一名17岁女性、一名10岁男孩和一名24岁女性,他们均因食管静脉曲张破裂出现严重上消化道出血。前两名患者采用杉浦(Sugiura)技术进行门脉减压手术,手术成功。他们术后目前分别存活3年和9年,体格检查和肝功能检查均正常。第三名患者入院后不久因并发严重化脓性胆管炎死亡。