• 제목/요약/키워드: Common duct

검색결과 257건 처리시간 0.026초

Congenital web of the common bile duct combined with multiple intrahepatic duct stricture: a case report of successful radiological intervention

  • Lim, Hanseul;Hwang, Shin;Ko, Gi-Young;Han, Hyejin
    • 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.

공동주택의 세대별 균등 배기량을 확보 하는 제어방법에 관한 연구 (Control Method to Ensure Uniform Exhaust Function by Household of Apartment House)

  • 권용일
    • 설비공학논문집
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    • 제29권12호
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    • pp.628-637
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    • 2017
  • This study was conducted to present an effective control method for the common duct system to uniformly discharge volume flow rate exhausted from the kitchen and bathroom of each household in an apartment regardless of the position of household. Since the common duct system is installed vertically and the ventilator is installed in the terminal, the static pressure of each household decreases when vertical height increases. Therefore, the volume flow rate exhausted from each household is different. In order to improve such a phenomenon, a constant air volume damper shall be installed in a branch duct coupled with a common vertical duct system. The selected ventilator should also be able to handle the maximum volume flow rate considering diversity factor. Therefore, a uniform volume flow rate must be exhausted from all households where the hood is operated. This paper mainly focuses on suggestion of an optimum exhaust control method by comparing exhaust performance of each household according to the presence or absence of a constant air volume damper.

Duplicated extrahepatic bile duct (type Vb): An important rare anomaly

  • Vaibhav Kumar Varshney;Sabir Hussain;N. Vignesh;B. Selvakumar;Lokesh Agarwal;Taruna Yadav
    • 한국간담췌외과학회지
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    • 제27권2호
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    • pp.220-225
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    • 2023
  • Congenital duplication of the extrahepatic bile duct (DEBD) is an unusual anomaly of the biliary system. It occurs due to inability of the embryological duplex biliary system to regress. DEBD has various subtypes depending on the morphology and opening of the aberrant common bile duct. It can have distinct complications. We encountered a 38-year-old lady who experienced pain in the right upper abdomen along with a low-grade fever. Magnetic resonance cholangiopancreatography revealed DEBD with multiple calculi in the right hepatic duct (ductolithiasis) and joining of the right hepatic duct with the left hepatic duct in the intrapancreatic region. Endoscopic retrograde cholangiography failed to clear the calculi from the right duct. They were then managed by common bile duct exploration and roux-en-Y right hepaticojejunostomy for biliary drainage. Her postoperative period was uneventful. She is currently doing well after three months of follow-up. Hence, a proper preoperative delineation of such rare anomalies is essential. It could avoid inadvertent injury to the bile duct and operative complications.

총담관 결찰이 집토끼 십이지장 점막내 배상세포의 미세구조에 미치는 영향 (An Ultrastructural Study on the Duodenal Goblet Cells of Rabbit after Common Bile Duct Ligation)

  • 김인호;양남길;안의태;고정식;박경호
    • Applied Microscopy
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    • 제20권1호
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    • pp.51-64
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    • 1990
  • This experiment was performed to study the morphological changes of the goblet cells in the rabbit duodenal mucosa after common bile duct ligation. Healthy adult rabbits weighting about 2kg body weight were divided to normal and bile duct ligated groups. Common bile duct ligation was performed under ether anesthesia. Experimental animals were sacrificed on the 1st, 3rd, 5th, 7th and 14th day after the operation. Mucosal specimens from the upper part of duodenum were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde, followed by 1% osmium tetroxide, embedded in araldite mixture, cut with LKB-V ultratome, stained with uranyl acetate - lead citrate, and observed with JEM 100 CX II electron microscope. Observed results were as follow : 1. In the early stages(1st-5th day) of the experiments, the goblet cells showed apocrine and merocrine secretion. But those of the late stage(7th and 14th day) groups showed exocytotic merocrine secretion. 2. In the late stage of the experiments, there found than increase of newly formed goblet cells that contain electron lucent cytoplasms. 3. In the goblet cells of normal rabbit, mucous granules with higher or lower electron densities are found together in the cytoplasm, and electron lucent mucous granules occasionally fused together. But in the early stage of the common bile duct ligation, goblet cells contained granules of higher electron densities. 4. Considering the above findings, common bile duct ligation probably initiates the hypersecretion of mucous granules of goblet cells in the early stage, and may facilitate the differentiation of goblet cells in the later stage.

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Asymptomatic Bile Duct Dilatation in Children: Is It a Disease?

  • Son, Yeo Ju;Lee, Mi Jung;Koh, Hong;Kim, Seung
    • 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.

갑상설관 낭종에서 발생한 유두상 선암 1예 (A Case of Papillary Thyroid Carcinoma Arising in Thyroglossal Duct Cyst)

  • 이경근;안해선;이광만
    • 대한두경부종양학회지
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    • 제16권1호
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    • pp.83-86
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    • 2000
  • Thyroglossal duct cyst is common midline mass, which is related to hyoid bone and may show signs of inflammation. Carcinoma arising in the thyroglossal duct cyst is rare, occuring in less than 1% of thyroglossal duct cyst. Papillary adenocarcinoma is the most common histologic type(75-85%). The initial treatement of choice is wide excision of the tumor bearing tissue(Sistrunk procedure), resection of associated lymph node alone is enough when they are small and isolated, but a modified neck dissection must be done if regional involvement is more extensive. Its prognosis is excellent(the incidence of regional lymph node metastasis is 7% compare to 89% for papillary cancer of thyroid gland proper).

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영아에서 발생한 총담관 자연 천공 1례 (A Case of Spontaneous Perforation of the Common Bile Duct in Infant)

  • 남기세;김종민;정기섭;한석주
    • 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.

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Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma

  • Park, Yun Chul;Jo, Young Goun;Kang, Wu Seong;Park, Eun Kyu;Kim, Hee Jun;Kim, Jung Chul
    • Journal of Trauma and Injury
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    • 제30권4호
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    • pp.231-234
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    • 2017
  • Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient's condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

Complete Transection of the Cystic Duct and Artery after Blunt Trauma: A Case Report

  • Cho, Sung Hoon;Lim, Kyoung Hoon
    • Journal of Trauma and Injury
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    • 제34권4호
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    • pp.294-298
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    • 2021
  • Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

Combined Hepatocellular-Cholangiocarcinoma in Extrahepatic Bile Duct with Co-existing of Scirrhous Type of Hepatocellular Carcinoma

  • Sang Hoon Lee;Moon Jae Chung
    • Journal of Digestive Cancer Research
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    • 제2권1호
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    • pp.32-36
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    • 2014
  • We report a patient with combined hepatocellular-cholangiocarcinoma confined in the common hepatic duct and scirrhous type of hepatocellular carcinoma in the caudate lobe of liver simultaneously. The patient was a 55-yearsold Korean man with hepatitis B virus (HBV) carrier who was referred from a local hospital due to detected liver mass on abdominal computed tomography (CT). He has presented jaundice and weight loss for the previous 3 weeks. Laboratory examination showed AST/ALT elevation and hyperbilirubinemia. HBsAg was positive. The tumor marker study showed elevated AFP and DCP, not CEA and CA 19-9. Abdominal CT disclosed an about 2.1×0.9 cm sized soft tissue density in hilum with both intrahepatic duct (IHD) dilatations and an about 3×2.1 cm sized arterial enhancing lesion at segment 8 of the liver. Patient received 15 cycles of Gemcitabine/Cisplantin chemotherapy from February 27, 2013 to December 31, 2013. Caudate lobectomy of liver, segmental resection of bile duct and Roux-en-Y hepaticojejunostomy was performed on February 10, 2014. The final pathologic report showed double primary liver cancer, combined hepatocellular-cholangiocarcinoma in common hepatic bile duct and scirrhous type of hepatocellular carcinoma in segment 1 of the liver. This is a very unusual case in which combined hepatocellular-cholangiocarcinoma confined in the large bile duct and two rare hepatic cancers coexisted.

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