AMPUTATION NEUROMA AFTER CHOLECYSTECTOMY ATTRIBUTED TO REPEAT CHOLANGITIS-CASE REPORT-

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  • 胆管炎を繰り返した胆嚢摘出術後断端神経腫の１例

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Abstract

A 78-year-old male patient presented with intermittent episodes of high fever and jaundice over the course of 4 years and was admitted. He had had a cholecystectomy 10 years prior to admission. Under a diagnosis of cholangitis due to benign biliary stricture, endoscopic retrograde biliary drainage was introduced to control the infection. It was difficult to control the infection, and the patient was referred to our department. Cholangiography revealed a stricture of the upper bile duct and hepatolithiasis. The patient underwent a bile duct resection, lithotomy, and a Roux-en Y hepaticojejunostomy. Histological examinations of the stricture revealed thick fibrous tissue with prominent proliferation of nerve fibers. As a result, the lesion was diagnosed as an amputation neuroma. Although it is a rare type of lesion, amputation neuroma should be considered in the differential diagnosis of bile duct stricture in patients with previous biliary surgery. Surgical intervention is strongly recommended, when a biliary stricture caused by an amputation neuroma is implicated in repeat episodes of cholangitis.

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