Two Cases of Eosinophilic Cholangitis Caused Biliary Obstruction

Yohsuke Yagawa, Hideki Yasuda, Maki Sugimoto, Keiji Koda, Masato Suzuki, Masato Yamazaki, Tohru Tezuka, Chihiro Kosugi, Ryota Higuchi and Yoshihisa Watayo

Department of Surgery, Teikyo University Chiba Medical Center

We report two cases of eosinophilic cholangitis caused biliary obstruction. Case 1: A 53-year-old woman referred for an abnormal biliary shadow in the liver found in a medical checkup was found in cholangiography to have a local biliary obstruction in the lateral segment of the liver. Suspecting cholangiocarcinoma, we conducted hepatic left lobectomy. Histopathologically resected specimen showed dense eosinophilic infiltration in the obstructive part of the bile duct. The postoperative course has remained uneventful in the 18 months since surgery. Case 2: A 87-year-old woman with right hypochondrial pain, was found in cholangiography to have local obstruction and a stone in the lower bile duct. Histopathological diagnosis from biopsy of this lesion showed dense eosinophilic infiltration but no malignant cell. She was underwent endoscopic biliary dilation and endoscopic stone removal, and has remained symptom-free in the 17 months since surgery. Insofar as we could determine, there were only 18 cases have been reported as eosinophilic cholangitis. Some cases had been conducted invasive surgery for suspicious of malignancy. Recently increase of the clinical reports has made the entity of this disease elucidated gradually, it is thought the treatment with the endoscope becomes subject. Given the need for awareness of this clinical entity and for appropriate diagnosis, eosinophilic cholangitis should be treated by minimal invasion.

Key words
eosinophilic cholecystitis, eosinophilic cholangiopathy, endoscopic biliary balloon dilation

Reprint requests
Yohsuke Yagawa Department of Surgery, Teikyo University Chiba Medical Center
3426-3 Anesaki, Ichihara, 299-0111 JAPAN

Accepted
December 19, 2007

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