無症状候性から症候性まで11年間経過観察しえた原発性硬化性胆管炎の1例

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In 1980, a 64-year-old female was first admitted to our hospital after pointing out of liver injury in a mass survey. A mild elevation of serum ductal enzymes were observed on the laboratory data. And histological findings of the liver revealed fibrous expansion and inflammatoric change of portal area. However, the common bile duct appeared to be normal on drip infusion cholangiography and normal colonogram was obtained. After 7 years she admitted for liver examination again. Ductal enzymes had remarkably elevated, and ERCP demonstrated typical beaded appearance in the whole biliary tree. In addition, barium enema examination showed a loss of haustral marking and the presence of small ulcers of the colon. In the present case, the lesion extended from the intrahepatic bile duct to the extrahepatic bile duct, and intrahepatic PSC preceded UC. In 1988, she first showed jaundice and then ursodeoxycholic acid (UDCA) was administered. Although UDCA improved the elevation of ductal enzymes, recurrent jaundice has been sustained. No significant change was shown in cholangiogram by the examination of follow-up ERCP. Now she is suffering from decompensated liver cirrhosis due to PSC.
社団法人日本肝臓学会の論文