Document Detail


A case of benign bile duct stricture causing difficulty in differential diagnosis from bile duct carcinoma.
MedLine Citation:
PMID:  15754049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a patient with benign bile duct stricture causing difficulty in differential diagnosis from bile duct carcinoma. A 66-year-old woman consulted a local physician because of general fatigue. Blood biochemical tests showed increased levels of biliary tract enzymes. Abdominal ultrasonography (US) revealed tapering and blockage of the midportion of the bile duct and dilation of the intrahepatic bile ducts. Magnetic resonance cholangiopancreatography (MRCP) demonstrated obstruction of the midportion of the bile duct. Later, because a marked increase in biliary tract enzymes and jaundice appeared, percutaneous transhepatic biliary drainage (PTBD) was performed. Post-PTBD cytological examination of bile was negative for cancer. A third biopsy showed slight hyperplasia with no malignant findings. Recholangiography, performed through PTBD, suggested gradual improvement of bile duct stricture, but could not completely exclude the possibility of malignancy; thus, resection of the bile duct including the stricture site was performed, and the resected specimen was submitted for intraoperative frozen section examination. Histopathological diagnosis did not reveal malignant findings. After cholecystectomy and bile duct resection, hepaticojejunostomy (Roux-en-Y) was performed. Because only erosion and desquamation of the mucosal epithelium and mild submucosal inflammatory cell infiltration and fibrosis were observed, chronic cholangitis was diagnosed histopathologically. Surgical resection of the bile duct should be considered for potentially malignant stricture of the bile duct.
Authors:
Hisafumi Kinoshita; Jun Nagashima; Mitsuo Hashimoto; Kazunori Nishimura; Takahito Kodama; Hideki Matsuo; Shigeru Hamada; Masafumi Yasunaga; Masaharu Odo; Shuichi Fukuda; Masao Hara; Koji Okuda; Mamoru Hiraki; Kazuo Shirouzu; Shigeaki Aoyagi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic surgery     Volume:  11     ISSN:  0944-1166     ISO Abbreviation:  J Hepatobiliary Pancreat Surg     Publication Date:  2004  
Date Detail:
Created Date:  2005-03-08     Completed Date:  2005-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431940     Medline TA:  J Hepatobiliary Pancreat Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  64-8     Citation Subset:  IM    
Affiliation:
Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Bile Duct Neoplasms / pathology*
Bile Ducts / pathology*,  ultrasonography
Biopsy
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Constriction, Pathologic
Diagnosis, Differential
Female
Frozen Sections
Gallbladder / ultrasonography
Humans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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