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急性膽囊炎 및 肝膿瘍을 同伴한 廣範圍한 膽道炎

The Extensive Cholangitis in Association with Acute Cholecystitis and Liver Abscess

대한외과학회지 1964년 6권 4호 p.203 ~ 207
李光鏞, 孫基燮,
소속 상세정보
李光鏞 (  ) - 延世大學校 醫科大學 外科學敎室
孫基燮 (  ) - 延世大學校 醫科大學 外科學敎室

Abstract


Chlolangitis lenta, which is a clinical manifestation of a biliary tract inflamation is association with sepsis but without demostrable cause of the inflamation such as stone or tumor, which pathologically periductal fibrotic narrowing of the lumen and biliary cirrhosis, had designated by Schottmuller(1921).
Cases of this type are rare and it is probable that it has not yet been reported in Korea. The authorse experianced a case of this type. A thirty-one year-old man of ROKAF was referred to the department of the surgery of the Aeromedical Center because of pain and tenderness in the right upper quadrant and progressive jaundice.
Physical examination revealed that the abdomen was distended, the edge of the liver was tender and was palpable three finger breadths below the right costal margin and muscle ligidity and rebound tenderness were noted in the upper abdomen.
Then under diagnosis of acute cholecystitis laparatomy was, performed. The exploration revealed the gall bladder was markedly distended but no stone or parasite was observed. Both lobe of the liver were enlarged about two or three times respectively, and the surface of those were covered with miliary like pus clots and a multitude of induration were notic ed in the liver. The common bile duct showed that the lumen was very narrow. The periductal region was very hamorrhagic and had inflamatory sign. The gall bladder was removed and the most slender T-Tube was remained in the common bile duct and liver biopsy was done also.
But about 4 weeks after first operation the liver abscess developed. Therefore incision and drainage of the abscess was done and abont 500 ㏄ of pus was evacuated.
The post operative course was uneventiful and recovered well. Patient returned to his duty after 3 months hospitalization.
The tissue taken from the liver shows the cholangitis and cholangiolitis with severe periductal necrosis.

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