The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Intraductal Papillary Mucinous Neoplasm of the Bile Ducts Accompanied bya Choledochoduodenal Fistula

총담관-십이지장 누공을 동반한 담관 내 점액성 유두 종양

  • Kim, Hyung-Tae (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Sa-Il (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kwon, Oh-Wan (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Hang-Lak (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Jun, Dae-Won (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Oh-Young (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Choi, Ho-Soon (Department of Internal Medicine, Hanyang University College of Medicine)
  • 김형태 (한양대학교 의과대학 내과학교실) ;
  • 김사일 (한양대학교 의과대학 내과학교실) ;
  • 권오완 (한양대학교 의과대학 내과학교실) ;
  • 이항락 (한양대학교 의과대학 내과학교실) ;
  • 전대원 (한양대학교 의과대학 내과학교실) ;
  • 이오영 (한양대학교 의과대학 내과학교실) ;
  • 최호순 (한양대학교 의과대학 내과학교실)
  • Published : 2011.07.01
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Abstract

An intraductal papillary mucinous neoplasm of the bile ducts (IPMN-B) is an uncommon tumor characterized by the secretion of large amounts of mucin and intraductal growth. The characteristic clinical symptoms and radiologic findings are due to bile-duct obstruction caused by mucin. A parapapillary choledochoduodenal fistula is a rare disorder. This fistula has no clinical symptoms and is diagnosed by chance. We report a case of parapapillary choledochoduodenal fistula associated with IPMN-B. A 63-year-old woman was admitted to Hanyang University Hospital because of jaundice. Computed tomography (CT) showed diffuse intra- and extrahepatic bile duct dilatation. The ducts were filled with heterogenous material. Duodenoscopy revealed a large choledochoduodenal fistula. Endoscopic retrograde cholangiography through the fistula showed a papillary mass in the common hepatic duct. IPMN-B with choledochoduodenal fistula was diagnosed. The patient underwent a left hepatectomy. Her postoperative course was uneventful, and she was observed regularly in the outpatient department.

담관 내 점액성 유두 종양이 다른 장기와 누공을 형성한 증례보고는 저자들이 문헌고찰한 것에 의하면 없으며, 누공형성 기전도 확립된 것이 없어 더 많은 보고와 연구가 필요하다. 저자들은 황달과 가려움증으로 내원하여 총담관-십이지장 누공을 동반한 담관 내 점액성 유두 종양을 진단하였으며, 간좌엽 절제술 및 담낭절제술로 치료한 증례를 경험하여 보고한다.

Keywords

References

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