A Case of Bile Duct Adenoma Associated with Acute Obstructive Suppurative Cholangitis

Yoshiaki Murakami, Takashi Kodama, Yoshio Takesue, Mitsuaki Okita, Atsushi Nakamitsu, Yuji Imamura, Hitoshi Sewake, Hiroaki Tsumura, Katsunari Miyamoto, Yuichiro Matsuura, Takashi Yokoyama*

The First Department of Surgery, General Medicine*, Hiroshima University School of Medicine

A case of bile duct adenoma associated with acute obstructive suppurative cholangitis (AOSC) due to its mucin production is described. A 63-year-old woman complaining of fever elevation, abdominal pain and jaundice was admitted to our hospital. She was diagnosed as having AOSC by blood examination and imaging examination. Percutaneous transhepatic biliary drainage was performed and cholangiography showed dilatation of the left intrahepatic bile duct and a spheroid-shaped filling defect in the extrahepatic bile duct. Since choledocholithiasis with dilatation of the left intrahepatic bile duct was suspected, a left hepatectomy and a Roux-en Y hepaticojejunostomy were performed. There were no stones but much mucin in the intrahepatic bile duct and choledochus. Subsequent pathological examination of the surgical specimens revealed a bile duct adenoma with mucin production. This case was interesting from the viewpoint of showing hepatolithiasis-like symptoms. Recently reports of benign epithelial tumors and mucin producing tumors of the bile duct have increased. Further investigation of these tumors is needed.

Key words
bile duct adenoma, mucin producing tumor of the biliary tract, acute obstructive suppurative cholangitis

Reprint requests
Yoshiaki Murakami First Department of Surgery, Hiroshima University School of Medicine
1-2-3 Kasumi, Minami-ku, Hiroshima, 734 JAPAN

Accepted
December 12, 1990

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