ABSTRACT
An 87-year-old man visited his previous doctor because of jaundice, abdominal pain, and disturbance of consciousness. He was diagnosed with cholangitis and panperitonitis and was referred to our hospital. Emergency laparotomy revealed biliary peritonitis. However, the bile leak point was unclear. Two days after surgery, endoscopic retrograde cholangiopancreatography was performed and revealed hilar bile duct stenosis, slight dilation of the intrahepatic bile duct, and bile leakage from the peripheral left intrahepatic bile duct to the abdominal free space. Endoscopic nasobiliary drainage was performed, and bile leakage decreased. He was discharged from our hospital with improvement from jaundice and peritonitis. Intrahepatic bile duct rupture with neoplastic obstruction of the bile duct is extremely rare. To date, only two cases of intrahepatic bile duct rupture with intrahepatic cholangiocarcinoma have been published.
Subject(s)
Bile Duct Neoplasms , Cholangiocarcinoma , Peritonitis , Male , Humans , Aged, 80 and over , Bile Ducts, Intrahepatic/diagnostic imaging , Bile Ducts, Intrahepatic/pathology , Cholangiocarcinoma/complications , Cholangiocarcinoma/diagnostic imaging , Cholangiocarcinoma/surgery , Bile Ducts/pathology , Bile Duct Neoplasms/complications , Bile Duct Neoplasms/diagnostic imaging , Bile Duct Neoplasms/surgery , Cholangiopancreatography, Endoscopic Retrograde , Peritonitis/diagnostic imaging , Peritonitis/etiology , Peritonitis/surgeryABSTRACT
We report here two cases of neuroendocrine carcinoma which occurred in the biliary system. The prognosis of neuroendocrine carcinoma in the biliary system is generally poor. However, based on the preoperative pathological diagnosis of neuroendocrine carcinoma, multidisciplinary treatment consisting of preoperative chemotherapy, chemoradiation therapy, curative resection and adjuvant chemotherapy seemed to be very effective and long-term survival was obtained in our two cases. Therefore it is essential to diagnose preoperatively to improve prognosis.