Case of Mucus-producing Intracholecystic Papillary Neoplasm Causing Acute Obstructive Cholangitis
نویسندگان
چکیده
症例は71歳，男性．主訴は背部痛，心窩部痛．前医CTで胆嚢腫大，胆嚢内に乳頭状に拡がる隆起性病変，乳頭から肝内胆管に及ぶ軽度の胆管拡張および胆嚢結石を指摘され紹介受診．入院精査の予定だったが，5日後に右背部痛が増悪し閉塞性黄疸の増悪，白血球数高値であり，急性胆管炎の診断で緊急入院となった．同日，内視鏡的逆行性胆管膵管造影を施行し，経鼻胆道ドレナージチューブを留置された．自然流出では多量の粘液によりチューブ閉塞をきたし，連日洗浄を行うことで減黄が得られた．胆嚢内に充満する乳頭状腫瘍と十二指腸乳頭からの粘液排出から胆嚢内乳頭状腫瘍（intracholecystic papillary neoplasm:ICPN）が疑われ，開腹胆嚢摘出術の方針とした．術中超音波を用いて肝浸潤が無いことを確認し，全層胆摘を施行した．病理組織診断ではbiliary typeまたはoncocytic typeのICPNと考えられる所見であった．
منابع مشابه
Intracholecystic papillary-tubular neoplasm of the gallbladder presenting with jaundice.
We herein report a case of intracholecystic papillary-tubular neoplasm (ICPN) of the gallbladder in which jaundice developed. A 58-year-old woman with jaundice was referred to our hospital. Computed tomography revealed a papillary tumor in the body of the gallbladder protruding into the bile duct. A transpapillary biopsy of the bile duct verified adenocarcinoma, and pancreatoduodenectomy with e...
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ژورنال
عنوان ژورنال: Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)
سال: 2021
ISSN: ['1345-2843', '1882-5133']
DOI: https://doi.org/10.3919/jjsa.82.2275