10年前の交通外傷が原因と考えられた左肝管狭窄の1例

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  • A RESECTED CASE OF STRICTURE OF THE LEFT HEPATIC DUCT PROBABLY CAUSED BY A TRAUMA DUE TO TRAFFIC ACCIDENT 10 YEARS BEFORE

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We experienced a case of stricture of the left hepatic duct which might be caused by a trauma in a traffic accident 10 years before.<br> A 50-year-old man was admitted to the hospital because of a right hypochondralgia and fever. Ultrasonography, CT, and percutaneous transhepatic cholangiography (PTC) revealed a marked dilatation of the left intrahepatic bile duct. From cytodiagnosis of bile juice, the patient was suspected of having an intrahepatic bile duct carcinoma and underwent a left lobectomy of the liver. The resected specimen disclosed no malignancy. It was etiologically thought that the bile duct stricture might be caused by abdominal trauma in a traffic accident 10 year before. In a review of the Japanese literature, 23 cases of traumatic stricture of the bile duct have been seen, but the time intervals from the accident to the onset of the disease were in 2 to 4 weeks in most cases. This case appeared the most delayed case.<br> In the treatment of patients with a previous of sufferring from abdominal trauma, traumatic stricture of the bile duct should be first suspected as a probable diagnosis irrespective of whether the trauma occurred recently or not.

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