총간관의 종괴로 나타난 간흡충증 1예
A Case of Clonorchiasis Presenting as Common Hepatic Duct Mass
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
간흡충(Clonorchis sinensis)은 우리나라에서 대변검사로 진단되는 윤충 감염증 중 감염률 1위를 차지하는 음식물 매개성 기생충으로서 성충은 말초 간내담관, 간외담관, 드물게는 담낭 또는 췌관 등에 존재하며 오래 지속되면 합병증으로 담관결석, 재발성 화농성 담관염, 담관농양, 담관협착 및 담도암을 일으킬 수 있다. 간흡충증의 담관조영상은 성체에 의한 충만결손, 말초담관의 폐색, 불규칙하거나 희미한 담관, 미만성 간내담관 확장, 간내 다관징후 등의 소견을 보이나 간외담관에 종괴를 형성하여 폐쇄를 일으키는 경우는 매우 드물다. 저자들은 간헐적 복통을 주소로 내원한 54세 여자 환자에서 종괴를 형성하여 총간관폐쇄를 유발하여 간문부 담관암과 유사하게 보였으나, 내시경 역행성 담관조영술 및 내시경으로 제거하여 치료한 간흡충증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
The liver fluke, Clonorchis sinensis is an important human parasite and is endemic in Eastern Asia including Korea, China, and Japan. Patients acquire the infestation by eating raw or undercooked freshwater fish. Radiologic examinations usually reveal dilated peripheral intrahepatic bile ducts and normal extrahepatic bile duct. The diagnosis of clonorchiasis may sometimes be difficult and a presentation as an obstructive mass at the common hepatic duct is a rare event. Here we report a case of clonorchiasis of 54-year- old woman presented with epigastric pain. Endoscopic retrograde cholangiography revealed a mass at the common hepatic duct with dilatation of the intrahepatic ducts mimicking cholangiocarcinoma. Using an endoscopic basket, muddy, sludge-like materials were extracted through the papillary orifice. We report this case with a review of literatures.
참고문헌 (20)
- "Evaluation of sonography and skin test in diagnosis of clonorchiasis at the Hyongsan-gang", pp.117~123 (1995)
- "Changing patterns of Clonorchis sinensis infections in Kyongbuk,Korea", 35, pp.155~164 (1997)
- "Epidemiological study of clonorchiasis and metagonimiasis along the Geum-gang", pp.9~16 (2002)
- "Infection status of Clonorchis sinensis in residents of Hamyang-gun,Gyeongsangnam-do,Korea", 40, pp.191~193 (2002)
- "Infestation state of Clonorchis sinensis in patients with pancreatobiliary diseases in Ulsan:based on bile examination", 66, pp.521~525 (2004)
- "Endoscopy and biliary parasites", 6, pp.139~152 (1996)
- "A clinical review on biliary clonorchiasis", 18, pp.503~510 (1986)
- "Clinical features in clonorchiasis", 27, pp.64~71 (1995)
- "Extrahepatic cholangiocarcinoma associated with clonorchiasis:CT evaluation", 28, pp.68~71 (2003)
- "Radiologic findings of clonorchiasis", 155, pp.1001~1008 (1990)
- "The clinical and cholangiographic picture of hepatic clonorchiasis", 34, pp.183~186 (2002)
- "ERCP finding in clonorchiasis", 1, pp.29~32 (1981)
- "ERCP finding in hepatic clonorchiasis", 13, pp.121~126 (1993)
- "Clonorchiasis in Korea", 28 (1990)
- "Promoting role of Clonorchis sinensis infection on induction of cholangiocarcinoma during two-step carcinogenesis", 32, pp.13~18 (1994)
- "A study on biliary stone diseases associated with clonorchiasis in West-Gyeongnam area", 43, pp.380~387 (1992)
- "Reliability of ultrasonography in the diadgnosis of clonorchiasis", 37, pp.507~510 (1989)
- "Unusual presentations of hepatic clonorchiasis", 58, pp.637~639 (2003)
- "A case of total biliary obstruction caused by clonorchiasis", 3, pp.189~194 (1998)
- "Miniscopes", 13, pp.33~48 (1999)