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Journal of Medical Case Reports

, 4:254

First Online: 07 August 2010Received: 23 October 2009Accepted: 07 August 2010DOI: 10.1186-1752-1947-4-254

Cite this article as: Lee, K. & Hong, T. J Med Case Reports 2010 4: 254. doi:10.1186-1752-1947-4-254

Abstract

IntroductionWe report an unusual presentation of a small hepatic cyst causing cholangitis.

Case presentationA 70-year-old Asian man was hospitalized for aggravated chronic pain in the right upper portion of his abdomen. Fever developed after admission. Laboratory tests revealed elevated hepatobiliary enzymes, inflammatory markers and carbohydrate antigen 19-9 without hyperbilirubinemia. Ultrasound and computed tomography demonstrated dilatation of the left intra-hepatic bile ducts. Endoscopic retrograde cholangiopancreatography showed that the right intra-hepatic bile ducts were normally filled with contrast medium, but the left intra-hepatic bile ducts were not seen in the confluence. A left hepatectomy was performed because a hidden malignancy could not be excluded. The surgical findings showed no tumor around the bile duct but rather a 2 cm cyst in segment four of Couinaud-s category of the liver around the hilum. The pathology report was a solitary non-parasitic hepatic cyst compressing the bile duct.

ConclusionA very small solitary hepatic cyst might cause hepatic duct stricture if it is located near the hepatic hilum, and should be considered in the differential diagnosis of a hepatic duct stricture.

AbbreviationsCTcomputed tomography

ERCPendoscopic retrograde cholangiopancreatography

IHBDintra-hepatic bile ducts

SNHCsolitary non-parasitic hepatic cysts

USultrasound.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-4-254 contains supplementary material, which is available to authorized users.

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Autor: Keunho Lee - Taeho Hong

Fuente: https://link.springer.com/







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