An autopsy case of obstruction of the intrahepatic portal vein lumina associated with cylindrical dilatation of the intrahepatic large bile ducts.

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An autopsy case of portal hypertension due to luminal obstruction of the intrahepatic portal veins associated with non-obstructive dilatation of the intrahepatic bile ducts is reported. The 65year-old female was diagnosed Banti's syndrome 10 years ago and cholecystectomy for cholelithiasis was performed 8 years ago. During period of the last two years, repeated hematemesis occurred. Splenctomy with perigastric devascularization was performed subsequently and she died of heart failure about two months later. At autopsy, the liver was slightly atrophic without cirrhosis. The hepatic hilum was enlarged and fibrotic. The common, bilateral and segment bile ducts were cylindrically dilated and showed histological pictures of chronic proliferative cholangitis. The intrahepatic large portal vein lumina were obstructed by organized thrombi and an extravasation via the damaged bile duct was noted around them. It is suggested that cholangitis in the hepatic hilum may provoke the intrahepatic portal venous thrombosis.
社団法人日本肝臓学会の論文