• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.161-167
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• 2022

Congenital web formations are extremely rare anomalies of the extrahepatic biliary tree. We herein report a case of common bile duct septum combined with multiple intrahepatic bile duct strictures in a 74-year-old female patient who was successfully treated with radiological intervention. The patient initially visited the hospital because of upper abdominal pain. Imaging studies revealed multifocal strictures with dilatation in both intra- and extrahepatic ducts; the final clinical diagnosis was congenital common bile duct web combined with multiple intrahepatic duct strictures. Surgical treatment was not indicated because multiple biliary strictures were untreatable, and the disease was clinically diagnosed as benign. The multiple strictures were extensively dilated twice through bilateral percutaneous transhepatic biliary drainage (PTBD) for 2 months. After 1 month of observation, PTBD catheters were successfully removed. The patient is doing well at 6 months after completion of the radiological intervention, with the maintenance of normal liver function. Congenital web of the bile duct is very rare, and its treatment may vary depending on the patterns of biliary stenosis. In cases where surgical intervention is not indicated for congenital web and its associated disease, radiological intervention with balloon dilatation can be a viable therapeutic option.

• 대한영상의학회지
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• 제82권4호
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• pp.964-970
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• 2021

이중 담관 기형은 매우 드문 선천 기형의 한 종류이다. 이중 담관 기형과 동반한 담관암의 증례가 보고된 적이 있으나 담관암의 전 침습적 병변인 관내 유두종이 이중 담관 기형과 함께 동반한 증례는 보고된 적이 없다. 우리는 64세 여성에게서 발견된 이중 담관 기형과 동반된 관내 유두종을 보고하고자 한다. 환자는 간 우엽 절제술을 시행하였으며 병리 결과에서 관내 유두종, 이중 담관 기형으로 진단되었다. 이에 대한 증례를 간단한 문헌 고찰과 함께 보고한다.

• 대한핵의학회지
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• 제30권1호
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• pp.126-129
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• 1996

Spontaneous perforation of CBD in infant is a rare but fatal disease. We report a case of bile leakage from common bile duct in 11 months old girl with progressive abdominal distension and vomiting, preoperatively diagnosed by hepatobiliary scan with 99mTc-DISIDA, which was confirmed by surgery, Operative cholangiogram showed a small perforation at the confluence of cystic duct and common bile duct with mild fusiform dilatation, and no definite abnormality in confluence of the common bile duct and pancreatic duct. Simple drainage of the free peritoneal bilous fluid and T-tube drainage were performed without any evidence of the complication. Patient was inevitable for 6 months OPD follow-up examination.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권3호
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• pp.180-186
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• 2015

Purpose: Bile duct dilatation is a relatively common sonographic finding; nevertheless, its clinical significance in children is controversial because little research has been done in the area. Therefore, we investigated the natural course and clinical significance of biliary duct dilatation in children. Methods: We performed a retrospective study of 181 children (range, 1-day-old to 17-year-old) in whom dilatation of the intrahepatic duct and/or common hepatic duct and/or common bile duct was detected by abdominal ultrasonography at the Severance Children's Hospital between November 2005 and March 2014. We reviewed and analyzed laboratory test results, clinical manifestations, and clinical course in these patients. Results: Pediatric patients (n=181) were enrolled in the study and divided into two groups. The first group included 59 subjects, without definitive cause of bile duct dilatation, who did not require treatment; the second group included 122 subjects, with definitive cause of bile duct dilatation or underlying biliary disease, who did require treatment. In the first group, 24 patients (40.7%) showed spontaneous resolution of bile duct dilatation, 20 patients (33.9%) showed no change, and 15 patients (25.4%) were lost to follow-up. In the second group, 31 patients were diagnosed with choledochal cysts, and 91 patients presented with biliary tract dilatations due to secondary causes, such as gallbladder or liver disease, post-operative complications, or malignancy. Conclusion: Biliary dilatation in pediatric patients without symptoms, and without laboratory and other sonographic abnormalities, showed a benign clinical course. No pathologic conditions were noted on follow-up ultrasonography.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권2호
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• pp.284-288
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• 2004

영아에서 담관의 자연 천공은 매우 드물며 조기에 발견하여 치료하지 않으면 사망할 수 있는 질환이다. 출생 후 건강하던 영아가 복부팽만, 복수, 황달이 나타나면 의심하게 되며 대부분 수술적 담도 조영술을 시행하는 과정에서 진단된다. 저자들은 복부팽만, 황달, 무담즙변 증상이 있는 생후 4개월 된 소아에서 총담관의 자연천공 1례를 경험하여 문헌 고찰과 함께 보고하는 바이다.

• Advances in pediatric surgery
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• 제9권2호
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• pp.81-88
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• 2003

Congenital dilatation of the common bile duct (choledochal cyst) is an uncommon disease. Although the etiology is unknown yet, various theories such as distal obstruction of the common bile duct, congenital weakness of the duct and anomalous union of the pancreaticobiliary duct have been offered to explain the occurrence of choledochal cyst. Thirty - six cases of choledochal cyst over 22 years were analyzed clinically and classified according to Todani's classification and Kimura's anomalous union of pancreaticobiliary duct type. Todani type 1 consisted with 22 cases which were subdivided into 19 cases of type Ia, 1 case of type Ib and 2 of type Ic. Type IVa consisted with 14 cases including one case of Caroli's disease. There were 25 type BP cases and 10 type PB cases and 1 normal pancreatobiliary junction. Serum alkaline phosphatase was increased significantly in almost all cases. Seven patients (19.4%) had associated congenital anomalies such as double gallbladder, left - sided gallbladder, common bile duct web, biliary atresia, accessory hepatic duct, heterotopic pancreas, cleft lip and 2 cases of intestinal malrotation. All patients underwent cyst excision and Roux - en - Y hepaticojejunostomy and cholecystectomy. There was one death due to methicillin resistant Staphylococcus aureus sepsis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권1호
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• pp.108-112
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• 2001

Nonsyndromic intrahepatic bile duct paucity is known to be associated with several kinds of etiology such as infection, chromosomal anomaly, metabolic disease and idiopathic. We report a rare case of intrahepatic bile duct paucity with congenital bilateral vocal cord paralysis and 13q deletion.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.121-124
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• 2014

Omega (${\omega}$)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nutrition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (${\omega}$)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including aminotransferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effectiveness of ${\omega}$-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.

• Journal of Digestive Cancer Research
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• 제2권2호
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• pp.78-81
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• 2014

담관암은 예후가 불량한 암으로 전암성 병변의 병리, 임상적 특징, 예후 등의 이해가 중요할 것으로 생각된다. 관내 유두상 종양은 드문 질환으로 만성적인 담관의 염증이 동반되어 있는 환자에서 발생 위험이 증가하며 비교적 느리게 성장하고 덜 침습적인 특징이 있으나 악성 전환 가능성이 높은 질병이므로 첫 진단 시 조직학적으로 양성이라 하더라도 적극적인 치료를 고려하도록 권고하고 있다. 이에 질병의 자연경과에 대한 보고는 적어, 저자들은 치료없이 8년간 경과 관찰하여 담관암으로 진행한 담관내 유두상 종양 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Clinical Endoscopy
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• 제51권6호
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• pp.541-546
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• 2018

Recent advances in cholangiopancreatoscopy technology permit image-enhanced endoscopy (IEE) for pancreatobiliary diseases. There are limitations in endoscopy performance and in the study of the clinical role of IEE in bile duct or pancreatic duct diseases. However, currently available IEEs during cholangiopancreatoscopy including traditional dye-aided chromoendoscopy, autofluorescence imaging, narrow-band imaging, and i-Scan have been evaluated and reported previously. Although the clinical role of IEE in pancreatobiliary diseases should be verified in future studies, IEE is a useful promising tool in the evaluation of bile duct or pancreatic duct mucosal lesions.