ID 110778
Author
Horie, Takahiro Department of Internal Medicine, Tokushima Prefectural Miyoshi Hospital
Shimizu, Ichiro Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
Okazaki, Michiyo Department of Internal Medicine, Tokushima Prefectural Miyoshi Hospital
Fujiwara, Kensuke Department of Internal Medicine, Tokushima Prefectural Miyoshi Hospital
Fujiwara, Soichiro Department of Internal Medicine, Tokushima Prefectural Miyoshi Hospital
Yamamoto, Koji Department of Internal Medicine, Tokushima Prefectural Miyoshi Hospital
Iuchi, Arata Department of Internal Medicine, Tokushima Prefectural Miyoshi Hospital
Tanagami, Akihito Department of Radiology, Tokushima Prefectural Miyoshi Hospital
Hirokawa, Mitsuyoshi Department of Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School
Ito, Susumu Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School Tokushima University Educator and Researcher Directory
Keywords
extrahepatic portal obstruction
stenosis of the intrahepatic bile duct
portal hypertension
Content Type
Journal Article
Description
A 51-year-old Japanese male with chief complaints of slightly high fever and epigastralgia was hospitalized at our facility. The inflammatory response was enhanced, and liver dysfunction was observed. Abdominal ultrasonography demonstrated a hyperechoic lesion occupying the left portal vein, and abdominal plain CT indicated a low density of the lesion with a clear boundary, measuring about 3 cm× 2 cm, between the porta hepatis and segment IV of the liver. Contrast CT showed no enhancement in the arterial and portal phases, but a reduction in the density inside the tumor in the equilibration phase was noted. MRI showed hypointensity by T1-weighted imaging and hyperintensity by T2-weighted imaging. Angiography demonstrated an obstruction of the left portal vein and superior mesenteric vein, and endoscopic retrograde cholangiography revealed a constriction in the left intrahepatic bile duct. Since the possibility of intrahepatic cholangiocarcinoma could not be excluded, extended left hepatectomy combined with caudate lobectomy was performed. The tumor, measuring 31 mm× 21 mm×20 mm, was pathohistologically diagnosed as an extrahepatic portal obstruction. Extrahepatic portal obstruction is an important disease that is sometimes difficult to rule out oncologic origin.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
52
Issue
3-4
Start Page
203
End Page
207
Sort Key
203
Published Date
2005-08
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
Medical Sciences