Mori W, Mukawa K
Acta Hepatogastroenterol (Stuttg). 1977 Apr;24(2):86-92.
A total of 10 autopsy cases who had received percutaneous transhepatic cholangiography (PTC) were examed and analysed from the view point of chronological changes of hepatic damage caused by the puncture. The conclusion obtained on the process of simple healing can be summarized as follows: (1) Hemocoagulation or hematoma formation on the hepatic surface and intra-peritoneal hemorrhage were seen until the 7th day after PTC but not in cases of the 13th day or later, while the scar of puncture was recognizable on the hepatic capsule in cases of up to the 16th day but was not remaining in ones of the 41st day and later. (2) Damage of the hepatic parenchyma was existing until the 7th day, which, however, was repaired by the 13th day. (3) Intra-hepatic hematoma was seen until the 13th day but faded away thereafter. Namely, intrahepatic trauma caused by PTC seems to be completely cured without leaving any scar in about a half month. However, the puncture trace on the diaphragm was seen in one case of the 42nd day after PTC examination, therefore the nature of diaphragmatic trauma seems to be somewhat different from that of the liver, including its capsule. Besides, discussions are also made on some hepatic complications caused by PTC, as well as on clinical significance of this kind of pathomorphological study.
对总共10例接受过经皮肝穿刺胆管造影(PTC)的尸检病例进行了检查,并从穿刺引起的肝损伤的时间变化角度进行了分析。关于单纯愈合过程得出的结论可总结如下:(1)在PTC后第7天之前可见肝表面的血液凝固或血肿形成以及腹腔内出血,但在第13天及以后的病例中未见,而在第16天及之前的病例中可在肝包膜上识别出穿刺瘢痕,但在第41天及以后的病例中则不存在。(2)肝实质损伤一直存在至第7天,但在第13天已修复。(3)肝内血肿在第13天之前可见,但此后逐渐消退。也就是说,PTC引起的肝内创伤似乎在大约半个月内完全治愈且不留任何瘢痕。然而,在PTC检查后第42天的1例病例中可见膈肌上的穿刺痕迹,因此膈肌创伤的性质似乎与肝脏包括其包膜的创伤性质有所不同。此外,还对PTC引起的一些肝脏并发症以及这种病理形态学研究的临床意义进行了讨论。