DOI QR코드

DOI QR Code

담낭염 환자에 동반된 간문부에서 기시하는 이중담관 기형 1예

A Case Report of Bile Duct Duplication Arising from the Hepatic Hilum

  • 공은정 (울산대학교 의과대학 서울아산병원 내과) ;
  • 장은경 (울산대학교 의과대학 서울아산병원 내과) ;
  • 윤용훈 (울산대학교 의과대학 서울아산병원 내과) ;
  • 안성희 (울산대학교 의과대학 서울아산병원 내과) ;
  • 현일식 (울산대학교 의과대학 서울아산병원 내과) ;
  • 황대욱 (울산대학교 의과대학 서울아산병원 외과) ;
  • 이성구 (울산대학교 의과대학 서울아산병원 내과)
  • Gong, Eun-Jeong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jang, Eun-Kyung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoon, Yong-Hoon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Seong-Hee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hyun, Yil-Sik (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hwang, Dae-Wook (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sung-Koo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2012.04.01

초록

간담도계는 해부학적 변형과 기형이 흔한 편이나 이중관 기형은 드물다. 특히 간문부에서 기시하는 이중담관은 현재까지 보고된 이중관 기형의 형태 분류에 속하지 않으며 영상학적 검사에서 이중담낭으로 오인되기 쉽다. 저자들은 증상이 있는 만성 담낭염 환자에서 동반된 간문부로부터 기시하는 이중담관 기형 증례를 문헌고찰과 함께 보고한다.

Anatomic variation in the hepatobiliary tract is relatively common, although bile duct duplication is rare. Detection of biliary tract variation is important because it is closely related to complications such as cholangitis, cholecystitis, pancreatitis, stone formation, and gastrointestinal tract malignancy. Therefore, preoperative imaging and a high index of suspicion are required to make an accurate diagnosis of a biliary tract anomaly. A 44-year-old woman presented with a 2-year history of epigastric pain after eating a meal and gallbladder sludge with chronic cholecystitis. The presumed diagnosis was gallbladder duplication. However, during surgery it was observed that the tubular structure was parallel with the fissure for the ligamentum venosum and ended at the lesser curvature of the stomach. The pathologic diagnosis was bile duct duplication. We report a case of a unique variant of bile duct duplication arising from the hepatic hilum.

키워드

참고문헌

  1. Kosar I, Ataseven H, Yonem O, et al. A new variant of bile duct duplication with coexistence of distal cholangiocarcinoma. Nat Rev Gastroenterol Hepatol 2010;7:527-530. https://doi.org/10.1038/nrgastro.2010.118
  2. Balbinot RA, Gobbato A, Balbinot SS, et al. Double bile duct with ectopic drainage into stomach. Gastrointest Endosc 2004;60:661-662. https://doi.org/10.1016/S0016-5107(04)01871-1
  3. Choi E, Byun JH, Park BJ, Lee MG. Duplication of the extrahepatic bile duct with anomalous union of the pancreaticobiliary ductal system revealed by MR cholangiopancreatography. Br J Radiol 2007;80:e150-e154. https://doi.org/10.1259/bjr/50929809
  4. Kim SW, Park DH, Shin HC, et al. Duplication of the extrahepatic bile duct in association with choledocholithiasis as depicted by MDCT. Korean J Radiol 2008;9:550-554. https://doi.org/10.3348/kjr.2008.9.6.550
  5. Min KS, Park JS, Jeong ES, et al. Case report of a double common bile duct with gallstone cholecystitis. Korean J Med 2011;80:208-211.
  6. Causey MW, Miller S, Fernelius CA, Burgess JR, Brown TA, Newton C. Gallbladder duplication: evaluation, treatment, and classification. J Pediatr Surg 2010;45:443-446. https://doi.org/10.1016/j.jpedsurg.2009.12.015
  7. Gorecki PJ, Andrei VE, Musacchio T, Schein M. Double gallbladder originating from left hepatic duct: a case report and review of literature. JSLS 1998;2:337-339.
  8. Saito N, Nakano A, Arase M, Hiraoka T. A case of duplication of the common bile duct with anomaly of the intrahepatic bile duct. Nihon Geka Gakkai Zasshi 1988;89:1296-1301.
  9. Yamashita K, Oka Y, Urakami A, Iwamoto S, Tsunoda T, Eto T. Double common bile duct: a case report and a review of the Japanese literature. Surgery 2002;131:676-681. https://doi.org/10.1067/msy.2002.124025
  10. Dohke M, Watanabe Y, Okumura A, et al. Anomalies and anatomic variants of the biliary tree revealed by MR cholangiopancreatography. AJR Am J Roentgenol 1999;173:1251-1254. https://doi.org/10.2214/ajr.173.5.10541098