Primary Intrahepatic Cholesterol Gallstones, Report of a Case T. Matsushiro 1 , Y. Sasaki 1 , T. Masuda 2 1Surgical Division, Tohoku Rosai Hospital 2The Second Department of Pathology, Tohoku University, School of Medicine pp.445-448
Published Date 1984/4/25
DOI https://doi.org/10.11477/mf.1403107008
  • Abstract
  • Look Inside

 The patient was a 45 year-old man with chief complaints of epigastralgia, fever and vomiting.

 ERCP showed one large radiolucent shadow in the gallbladder, and numerous in the lateral inferior area of the liver. However, no dilatation of the extrahepatic bile duct was seen. Serum lipid values were within normal limits. Cholecystectomy, choledochotomy with T-tube drainage and lateral segmentectomy were carried out. The large stone in the gallbladder was a combination stone, and those in the intrahepatic duct were mixed ones. Histological examination of the liver showed remarkable meander of the lateral inferior branch and slight grade pericholangitis. Lipid composition of the gallbladder bile was 2.1 mmol/l of cholesterol, 8.3 mmol/l of phospholipid, and 69.5 mmol/l of total bile acid, thus the lithogenic index of 0.3. Lithogenic index of the bile in the common duct was also 0.4.  We couldn't explain the formation of the gallstone in this patient even if we had referred to the former explanation on cholesterol solubility and reconsidered the complexity of cholesterol stone formation.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院