肝内型原発性硬化性胆管炎が強く疑われた1例

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  • A CASE OF PRIMARY INTRAHEPATIC SCLEROSING CHOLANGITIS

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A 72-year-old man was seen at another hospital because of itching of the skin and pointed out icterus on August 19, 1993. The patient was admitted to the hospital on the next day. On blood biochemical tests, total bilirubin, ALP, γ-GPT, and anti-nuclear antibody levels increased, GOT and GPT were in normal limit, and anti-mitchondrion antibody was negative. From abdominal ultrasonography, CT, and cholan-giography, cholecystolithiasis and inflammatory lesion of the intrahepatic bile duct were strongly suspect-ed, but a possibility of tumorous lesion of the porta hepatis could not be ruled out. So laparotomy was performed on September 14. During operation the porta hepatis was exposed and cholangioscopy was done, but no tumorous lesion was detected in the region. Cholecystectomy, choledocotomy. T tube drainage, and biopsy of the liver and bile duct were carried out. Based on histopathologic picture, cholangiographic findings, and clinical course, the definite diagnosis of primary intrahepatic sclerosing cholangitis was made.

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