十二指腸前門脈を合併した胆道閉鎖症の根治術前の肝組織所見の経時的変化

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In two cases of biliary atresia associated with preduodenal portal vein, liver biopsies were done twice for each patient to see chronological histologic changes before corrective radical surgery. The histology demonstrated significant information on early changes of the liver in such cases. In the first case, liver biopsies were obtained on the 3rd and 52th days of her life before radical operation performed on the 70th day. The first specimen showed almost normal appearance of the liver of a newborn, while the second revealed portal fibrosis, cholestasis and giant cell transformation typical in biliary atresia. In the second case, liver biopsies were done on the 26th and 56th days of his life and radical operation was performed on the 66th day. he first specimen exhibited moderate cholestasis and mild giant cell transformation without portal fibrosis. On the other hand, the second specimen showed severe giant cell transformation, portal fibrosis and ductular proliferation containing occasional bile plugs as often seen in biliary atresia. It is considered that extrahepatic biliary obstruction has been completed at birth in biliary atresia with preduodenal portal vein, because the pathogenesis of this particular entity is thought to be related to developmental anomaly. In our present cases, hepatic changes were minimal in the early days of life, and progressed rapidly with the time. It is, therefore, suggested that, hepatic changes in biliary atresia develops mainly after birth as the results of obstruction of the bile duct.
日本小児外科学会の論文
1986-08-20

十二指腸前門脈を合併した胆道閉鎖症の根治術前の肝組織所見の経時的変化

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