Korean J Gastrointest Endosc > Volume 31(4); 2005 > Article
Korean Journal of Gastrointestinal Endoscopy 2005;31(4): 278-280.
간내담관을 침범한 간세포암에서 발생한 혈액담즙증 1예
서울대학교 의과대학 내과학교실, 간연구소, *병리학교실
A Case of Hepatocellular Carcinoma Invading Intrahepatic Duct Complicated by Hemobilia
Soo-Jeong Cho, M.D., Ji Kon Ryu, M.D., Sun-Jung Myung, M.D., Cheol Min Shin, M.D., Dong Won Ahn, M.D., Su Jong Yu, M.D., Ji-Won Yu, M.D., Jin Ho Paik, M.D.*, Gyeong Hoon Kang, M.D.* and Hyo-Suk Lee, M.D.
Department of Internal Medicine and Liver Research Institute, *Department of Pathology Seoul National University College of Medicine, Seoul, Korea
A seventyone-year-old male presented with sudden epigastric pain followed by jaundice and intermittent right upper abdominal pain. He was diagnosed as hepatocellular carcinoma 7 years ago, and has been treated with transarterial chemoembolization, percuaneous ethanol injection and segmentectomy. On admission, the level of serum bilirubin, amylase and lipase were 8.7 mg/dL, 560 IU/L, and 13,297 IU/L, respectively. Stool occult blood test was positive. Abdominal computed tomography revealed newly- appeared intraductal soft tissue mass with ductal dilatation. Endoscopic retrograde cholangiography demonstrated filling defects in the common hepatic and distal common bile duct (CBD). Endoscopic sphincterotomy was performed and the clots in the distal CBD were removed. An intraductal stent was inserted at the common hepatic duct. The obstructive jaundice and pancreatitis were resolved. Our case suggests that intraductal hepatocellular carcinoma may induce hemobilia as a possible cause of acute pancreatitis. (Korean J Gastrointest Endosc 2005;31:278⁣281)
Key Words: Hepatocellular carcinoma, Hemobilia, Acute pancreatitis
주요어: 간세포암, 혈액담즙증, 급성 췌장염
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