Late-onset liver abscess due to cholangitis in congenital biliary dilatation

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  • 先天性胆道拡張症の晩期合併症として胆管炎から肝膿瘍を発症した一例

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Abstract

<p>A 10-month-old female patient with Todani Type IV-A congenital biliary dilatation underwent extrahepatic bile duct resection and intrahepatic cholangiojejunostomy. Multiple intrahepatic cysts were observed in her liver, and cholangiography during surgery showed them to be cystic dilatations of the peripheral bile ducts connecting to the main bile ducts. At the age of 11 years, she visited our hospital for fever and epigastric pain. Abdominal ultrasonography showed a 20-mm tumor containing solid cyst components and a posterior echo in the left lobe of her liver. Abdominal contrast-enhanced computed tomography showed that the tumor was not enhanced, and that the surrounding area was deeply stained in the early arterial phase. A hepatic abscess was diagnosed due to preoperative intrahepatic bile duct dilatation. She was admitted and treated with antibiotics. Her symptoms resolved, and she was discharged after 21 days with a remnant cystic lesion at the abscess site. She and her family refused surgical lobectomy. She was followed conservatively for 3 years and 5 months; there was no relapse of cholangitis or liver abscess. Postoperative patients with congenital biliary dilatation require careful follow-up for complications for a long period of time.</p>

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