総胆管結石を合併したｃｈｏｌｅｄｏｃｈｏｃｅｌｅに内視鏡的乳頭切開術を施行した１例

DOI 被引用文献2件 参考文献18件

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  • A Case of Choledochocele Associated with Common Bile Duct Stones Treated by Endoscopic Sphincterotomy.

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A case of choledochocele associated with common bile duct stones treated by endoscopic sphyncrerotomy is presellted. Patient was a 76-year-old man with past history of acute pancreatitis 22 years before. Upper gastrointestinal endoscopy revealed an elevated lesionsimilar to submucosal tumor in the second portion of the duodenum. Hypotonic duodenography showed a smooth-surfaced elevated lesion, 18×20 rnm in size, on the inner side of the middle second portion of the dtlodenum, which was thought to be an enlarged papilla of Vater. EUS showed a eystie mass in eentact with the eommon bile duet located inside the wall of the duodenum which contailled a stone with varied shapes. Duodenoscopy showed a smoothsurfaced semi-spherically enlarged papilla of Vater, which shape was varied according to contraction and relaxation of the sphincter of the papilla. ERCP showed a cystic dilatation of the terrninal portion of the common bile duct protruding in the duodenal lumen of the duodenurn, contailling a stone. Under the diagnosis of choledochocele associated with common bile duct stones, EST was performed alld stones were removed. ERCP about 2 years and 6 months after EST showed the cystic dilatation of the terminal portion of the common bile duct to have disappeared and neither stolle nor rnalignant change was detected. Biopsy specimell from thecavity of the choledochocele showed normal duodenal mucosa. When an enlarged papilla of Vater is found, choledochocele should be kept in mind as well as tumor of the papilla and common bile duct stones.

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