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Laparoscopy in a Case of Primary Sclerosing Cholangitis with an Ultrasonographically Detected Portal Thrombus
Author(s) -
WATANABE Makoto,
UCHIDA Yasushi,
KOHGE Naruaki,
AKAGI Shuji,
ASHIZAWA Nobuo,
ADACHI Kyoichi,
KISHIDA Keiko,
ONO Naomi,
FUKUMOTO Shiro,
ONO Masakazu
Publication year - 1992
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1992.tb00088.x
Subject(s) - medicine , radiology , abdominal ultrasonography , gallbladder , bile duct , primary sclerosing cholangitis , lesion , adenomyomatosis , cholangiography , thrombus , endoscopic retrograde cholangiopancreatography , biliary tract , angiography , gastroenterology , surgery , ultrasonography , pancreatitis , disease
A case of sclerosing cholangitis is presented. The patient was a 65 year‐old male and visited a hospital because symptoms of a biliary tract infection suddenly appeared. These symptoms improved in the short term with antibiotic therapy. As a high level of serum CA19–9 was found and the double wall structure of the intrahepatic bile duct and a portal thrombus were observed during an abdominal ultrasonography, the patient was transferred to our clinic for further examination of his hepatobiliary system. A malignant lesion was suspected from an endoscopic retrograde cholangiography and celiac angiography, although the patient's serum CA19–9 level rapidly decreased after admission. A liver with a smooth surface, some focal wide depressions, and an increase of white markings was observed laparoscopically. An adenomyomatosis‐like lesion was observed in the gallbladder. Bile duct destruction with periductar fibrosis was histologically proven. This is a case of histologically diagnosed sclerosing cholangitis but without the typical findings usually found during an endoscopic retrograde cholangiography.