肝臟血吸蟲病之超音波像：三例報告

日本血吸蟲病在臺灣比較少見，大部份病人是來自大陸的榮民。日本血吸蟲引起肝臟病變的致病機轉是由於蟲卵栓塞肝內門靜脈，引起肝門周圍纖維化，導致門脈高壓。病理切片檢查可以見到灰鉛管樣肝門纖維化。於超音波檢查時則可見到特異性的細網狀纖維化。本文報告3例日本血吸蟲肝臓病變的病例。病例一的肝臓超音波圖形呈現瀰漫細網狀纖維病變。病例二及病例三的肝臓超音波圖形爲局部細網狀纖維病變。3例皆經肝臟組織切片得到確定診斷。

關鍵字

血吸蟲病；超音波術

並列摘要

Schistosoma Japonicum infestation is confined to areas in the Far East. In Taiwan there is no evidence of locally acquired human infection and most reported cases came from Mainland China. Ultrasonographic features of periportal fibrosis induced by S. Japonicum had not been reported in the past. We present sonograms of 3 cases of periportal fibrosis induced by S. Japonicum in this report. The first case was a 57 years old male who suffered from urinary bladder stones with frequent hematuria for 4 years. A retroperitoneal hematoma containing ova of S. Japonicum with involvement of the sigmoid mesocolon was found during operation for cystolitholapaxy. Abdominal sonograms showed diffuse fine net-like linear shadows over the whole liver. Needle biopsy of the liver proved it to be schistosomal periportal fibrosis. The second case was a 51 years old male who complained of RUQ pain and body weight loss. Abdominal sonograms showed multiple gallstones and some high density linear echoes in the liver parenchyma with an ill-defined nodule within it. These features persisted for 7 months without changes. Wedge resection of the suspected nodule under echo-guidance was performed and pathologically it revealed to be hepatic schistosomiasis. The third case was a 59 years old male who complained of RUQ pain and poor appetite. Abdominal sonograms showed gallstones and also had some high density linear shadows in the liver with an ill-defined nodule. Operative wedge biopsy of the liver during cholecystectomy showed a feature of hepatic schistosomiasis.

並列關鍵字

hepatic schistosomiasis ； ultrasonography

國際替代計量

肝臟血吸蟲病之超音波像：三例報告

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