[症例報告]原因不明の総肝管良性狭窄の一例

概要

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A case of benign stricture of common hepatic duct possibly due to its perforation in a 66-year-old man is presented. The patient was referred to Ryukyu University Hospital on April 7, 1986, with a possible diagnosis of common bile duct cancer. His past history revealed that he had been hospitalized for jaundice during one month about 40 years ago. On admission, the patient appeard healthy with no abnormal physicaHindings. ERCP demonstrated the stricture and filling defect of the common hepatic duct and dilatation of the intrahepatic ducts. At surgery, the first loop of the duodenum was tightly adherent onto the strictured common hepatic duct, and the gallbladder was markedly atrophic. There was no stone within the gallbladder and bile ducts. Following cholecystectomy, T-tube cholangiography showed stricuture of the common hepatic duct on the anteroposterior view, but did not disclosed any stricuture of it on the lateral view. This cholangiographic finding was identical to that of perforation of the hepatic duct recently experienced in our clinic. Based on these data and literature review the cause of the stricuture was possibly considered to be the result of perforation of the common hepatic duct. The patient has been doing well 10 months after surgery.
琉球大学医学部,Faculty of Medicine, University of the Ryukyusの論文