Chinese Medical Sciences Journal ›› 2023, Vol. 38 ›› Issue (4): 309-314.doi: 10.24920/004273

• 病例报告 • 上一篇    下一篇

SpyGlass诊断肝细胞癌伴右肝管肿瘤血栓出血的一例

郭利华,缪敏,叶国良()   

  1. 宁波大学附属第一医院消化内科,浙江省宁波市,315020,中国
  • 收稿日期:2023-06-15 接受日期:2023-10-17 出版日期:2023-12-30 发布日期:2023-12-11
  • 通讯作者: 叶国良 E-mail:ndfyygl@163.com

SpyGlass in Diagnosis of Hepatocellular Carcinoma with Right Hepatic Duct Tumor Thrombus Hemorrhage: A Case Report

Li-Hua Guo,Min Miao,Guo-Liang Ye()   

  1. Department of Gastroenterology, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang 315020, China
  • Received:2023-06-15 Accepted:2023-10-17 Published:2023-12-30 Online:2023-12-11
  • Contact: Guo-Liang Ye E-mail:ndfyygl@163.com

摘要:

肝细胞癌伴胆管肿瘤血栓是一种相对罕见的疾病,预后较差。该病的主要临床表现是梗阻性黄疸,常被误诊。本例患者59岁,女性,因突发腹痛入院。实验室检查提示梗阻性黄疸,上腹部增强磁共振成像未见明显胆道扩张。超声内镜和内镜逆行胰胆管造影提示上胆管占位性病变,但性质不明。SpyGlass和活检最终证实肝细胞癌伴右肝管肿瘤血栓出血。SpyGlass直视系统作为一种先进的胆道镜设备,具有单人操作以及直视病灶且容易获取病理组织等优点。

关键词: 梗阻性黄疸, 肝癌, 胆管肿瘤血栓, SpyGlass

Abstract:

Hepatocelluar carcinoma presenting as a biliary duct tumor thrombus is a relatively rare entity, with poor prognosis. The primary clinical manifestation of this disease is obstructive jaundice, which can often be misdiagnosed. A 59-year-old female patient was admitted with sudden onset of abdominal pain. Laboratory tests suggested obstructive jaundice, and enhanced magnetic resonance imaging of the upper abdomen did not show obvious biliary dilatation. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography suggested an occupying lesion in the upper bile duct. SpyGlass and biopsy finally confirmed hepatocellular carcinoma with right hepatic duct tumor thrombus hemorrhage. The SpyGlass Direct Visualization System, as an advanced biliary cholangioscopy device, showed the advantages of single-person operation as well as easy access to and visualization of the lesion.

Key words: obstructive jaundice, hepatocellular carcinoma, bile duct tumor thrombus, SpyGlass

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