Obstructive Jaundice Caused by Polycystitc Liver Disease: Report of a Case

由多囊性肝疾病引起的阻塞性黃疸：一病例報告

陳宏昇(Hung-Sheng Chen) ； 陳冠仰(Kuan-Yang Chen)

《臺灣消化醫學雜誌》 30卷2期 (2013/06) Pp. 211-216

https://doi.org/10.6557/GJT.201306_30(2).0005

摘要

多囊性肝疾病是一種在肝臟中囊腫逐漸發生的疾病，通常都是到成年時才被發現。囊腫一開始都從膽管上皮衍生而出，之後慢慢和原有的肝內膽管分離而獨立於肝組織中。我們報告一位八十八歲的男性，因為逐漸的黃疸合併胃口變差及全身倦怠，懷疑是多囊性肝疾病引起，且經由逆行性內視鏡膽胰管攝影術確診。在肝門處有一巨大囊腫壓迫總肝管造成阻塞性黃疸，一開始嘗試逆行性內視鏡膽管引流並不成功，但在幾次經皮穿肝的肝囊腫引流合併囊腫內酒精注射後，膽管支架成功置放完成而膽汁可以被引流，檢查後無膽管惡性腫瘤的證據。因此，囊腫引流合併囊腫內酒精注射為有症狀的多囊性肝疾病可執行的第一線治療選擇。

關鍵字

多囊性肝疾病 ； 阻塞性黃疸

並列摘要

Polycystic liver disease (PCLD) is characterized by the progressive development of multiple cysts in liver, which are not usually diagnosed until adulthood. The cysts initially bud from biliary epithelium and subsequently lack continuity with the remaining biliary tree. Herein, the case of an 88-year-old man with a 2-week history of poor appetite, general weakness, and progressive jaundice is described. PCLD resulted in external compression of biliary tract was suspected and confirmed via endoscopic retrograde cholangiopancreatography. A large cyst externally compressing the common hepatic duct was identified. Endoscopic retrograde biliary drainage was attempted, but was not initially successful until after the cysts were aspirated and ethanol was injected to ablate the cysts. Neither gross nor microscopic evidence of malignancy was noted. Cyst drainage with subsequent ethanol injection in the initial stage of liver cyst ablation could be considered a first-line treatment option for patients with PCLD.

並列關鍵字

polycystic liver disease ； obstructive jaundice