肝左葉の萎縮を伴った肝内結石症の1例

Atrophy of the Left Lobe of the Liver Caused by Intrahepatic Bile Duct Stone and Cholangitis, Report of a Case

要旨　患者は64歳女性．右季肋部痛，発熱，全身倦怠感を訴えていた．肝胆道系酵素には異常は認めなかった．しかし，ERCPでは総胆管の中等度拡張と結石，および左肝内胆管の狭窄像を認めた．術前に肝内胆管癌を強く疑った．手術後，長期の胆管炎のためと，肝内結石によると考えられる肝左葉萎縮病変であることが判明した．

　The patient, a 64 year-old woman, has complained of right upper quadrant pain, fever, and general fatigue. There was no abnormality seen in the liver or biliary enzymes in the blood test.

　However, moderate dilatation of the biliary duct with several small stones and long stricture of the left intrahepatic bile duct with remarkably proliferated branches were demonstrated on ERCP films. Therefore, she was strongly suspected to have bile duct carcinoma before the surgical operation.

　By detection after the operation, this lesion was proved atrophy of the left lobe of the liver which was caused by intrahepatic biliary stones and cholangitis repeated for a long time.