腹腔镜胆囊切除术后胆道外伤性神经瘤1例报告并文献复习。

Hemn H Kaka Ali, Dana T Gharib, Marwan N Hassan, Ari M Abdullah, Deari A Ismaeil, Omar H Ghalib Hawramy, Dlshad H Ahmed, Dilan S Hiwa, Berun A Abdalla, Fahmi H Kakamad
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摘要

腹腔镜胆囊切除术已被发现与发展的创伤性神经瘤在极少数情况下。本文报告一例罕见的胆囊切除术后胆道外伤性神经瘤。本文报告一名47岁女性,有腹腔镜胆囊切除术的病史,主要表现为上腹部疼痛和厌食。经检查,发现巩膜有黄色变色。磁共振胆管造影显示近端胆管扩张,肝内胆道因狭窄而轻度扩张。术中可见硬胆管肿块伴肝周多发肿大淋巴结。患者最初被怀疑患有胆管癌;然而,切除肿块的组织病理学分析显示为胆管创伤性神经瘤。胆道创伤性神经瘤可能被低估,因为它们通常没有症状。不幸的是,由于创伤性神经瘤通常缺乏明显的特征,迄今为止,至少就我们所知,没有特别的胆管创伤性神经瘤的影像学表现。这种情况的罕见性,加上缺乏标准化的诊断模式,使得其诊断困难,甚至可能导致误诊为胆道癌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Biliary tree traumatic neuroma following laparoscopic cholecystectomy: A case report and literature review.

Laparoscopic cholecystectomy has been found to be associated with the development of traumatic neuromas on rare occasions. The present study reports a rare case of post-cholecystectomy biliary tree traumatic neuroma. Herein, a 47-year-old female with a history of laparoscopic cholecystectomy presented with upper abdominal pain and anorexia. Upon an examination, a yellow discoloration of the sclera was observed. Magnetic resonance cholangiopancreatography revealed a dilated proximal bile duct and mild dilatation of the intrahepatic biliary tree due to a stricture. Intraoperatively, a hard bile duct mass was observed with multiple enlarged lymph nodes in the peri-hepatic region. The patient was initially suspected to have bile duct cancer; however, a histopathological analysis of the resected mass revealed a bile duct traumatic neuroma. Biliary traumatic neuromas may be underestimated since they often remain asymptomatic. It is unfortunate that, as traumatic neuromas often lack distinguishing characteristics, no particular radiological findings for traumatic neuromas of the bile duct have been described to date, at least to the best of our knowledge. The rarity of this condition, combined with the absence of a standardized diagnostic modality, renders its diagnosis difficult and can even lead to misdiagnosis as biliary cancer.

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