혈액 담즙증으로 진단된 간내 담관 내 유두모양 담관암 1예
A case of hemobilia caused by an intraductal papillary neoplasm of the bile duct
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초록
Intraductal papillary neoplasm of the bile duct (biliary IPN) is a rare disease characterized by multicentric proliferation of adenomatous epithelium within the bile ducts. The common clinical manifestations are recurrent abdominal pain, jaundice, and acute cholangitis. We report a case of hemobilia caused by biliary IPN. A 59-year-old man was referred to our hospital because of hemobilia of unknown origin. Computed tomography and magnetic resonance cholangiography revealed dilatation of the S6 segmental duct with an ovoid-shaped intraductal mass. Percutaneous transhepatic cholangioscopy showed multiple papillary masses with bleeding in the S6 segmental duct. The patient underwent a right lobectomy, and the pathology revealed a well differentiated intraductal papillary adenocarcinoma.
Abstract
담관 내 유두모양 종양은 드문 질환으로 흔히 재발성 폐쇄성 황달이나 우상복부 동통, 담관염 등의 증상으로 나타난다. 혈액담즙증으로 발현하는 경우는 극히 드문 것으로 알려져 있다. 저자들은 담관 유두종에서의 혈액담즙증을 경험하였기에 문헌고찰과 함께 보고하는 바이며 원인 미상의 혈액담즙증 환자에서 담관확장이 관찰되는 경우 담도경 검사를 시행하여 담관 유두종에 의한 출혈을 감별하여야 한다.
참고문헌 (13)
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