自発性外胆嚢瘻を形成した胆嚢癌の1例  [in Japanese] A CASE REPORT OF SPONTANEOUS EXTERNAL BILIARY FISTULA OF THE GALLBLADDER WITH A CARCINOMA OF THE GALLBLADDER  [in Japanese]

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Abstract

胆嚢癌を基礎疾患とし,腹壁に腹嚢痩を形成した症例を経験した.患者は72歳の女性.右季肋部痛及び同部腫瘤形成,痩孔形成を認め,胆嚢腹壁穿孔と診断した.平成5年2月15日手術施行,胆嚢頸部に全周性の腫瘍性病変を認め,これを基礎にして外胆嚢痩を形成したものと考えた.本例には胆道外傷や胆道系に対する手術の既往は無く,いわゆる自発性外胆嚢痩の範躊に入るものである.自発性外胆嚢痩は稀な病態で,著者らの検索し得た限りでは,本邦報告例は現在迄30例に過ぎない.その多くは胆嚢結石を基礎に発症しており,胆嚢癌に伴った本症は自験例を含めても5例に過ぎない.また,過去4例の報告例は全例胆石症を合併していたが,自験例は胆嚢癌単独症例であり,極めて稀な病態であると考えられた.

A 72-year-old female was seen at the hospital because of a right hypochondralgia, fistula with purulent discharge, and painful mass at the right upper quadrant of the abdomen. Fistulography revealed the fistula from the gallbladder, and fistulectomy with cholecystectomy was performed. Postoperative pathological examination revealed stenosis of the cystic duct due to a gallbladder carcinoma with no malignancy of the fistula wall. The diagnosis was confirmed as spontaneous external biliary fistula, because these was no past history of undergoing any biliary tract surgery or trauma.<BR>In a review of the Japanese literature, only 29 cases of spontaneous biliary fistula were seen. Out of the 29 cases,24 cases developed the fistula due to an underlying disease of gallstone; four cases, gallstone and a carcinoma of the gallbladder; and one case, unknown. Accordingly, this case of spontaneous external biliary fistula is very rare that the fistula was etiologically the consequence of gallbladder carcinoma without stone.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 56(10), 2173-2178, 1995-10-25

    Japan Surgical Association

References:  16

Cited by:  1

  • A CASE OF CHOLECYSTOCUTANEOUS FISTULA  [in Japanese]

    SENDO Hiroyoshi , OSHIKIRI Taro , MAEDA Hiromi , FUJINO Yasuhiro , TOMINAGA Masahiro

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 72(11), 2899-2903, 2011-11-25

    Ichushi Web  References (13)

Codes

  • NII Article ID (NAID)
    10008516372
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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