Case Report: A 67-year-old woman's bile duct sildothe

February 2020, the Navy Military Medical University Changhai HospitalDigestiveDrNeko Panpeng, Professor Pai Yu, Li Zhaoshen, etcpublished a case report in the official journal Gut of the British Society of Gastroenterology, which reported a rare case of papilloma mucus tumor scurvy in a bile duct cathetera 67-year-old woman was admitted to hospital for "three months of upper abdominal pain", with no obvious jaundice during the course of the disease, and had a history of gallbladder removalThere were no obvious abnormalities in the physical examination and laboratory examinationMagnetic resonance pancreatic bile duct water imaging (MRCP) showed significant dilation of the hepatic and outer bile ducts and suspected intracellular bile duct stones (Figure 1)A computertomised tomography (CT) showed expansion of the hepatic and extracellular bile ducts and multiple hepatic bile duct stones (Figure 2)Figure 1MrCP shows significant expansion of the hepatic and external bile ducts and suspected hepatic biliary stonesFigure 2CT shows hepatic external bile duct expansion and multiple hepatic biliary tube stonesendoscopic pancreatic bile duct (ERCP) shows duodenal nipple "fish eye signs" and accompanied by a large amount of mucus outflow (Figure 3), the bile tube expansion to 24 mm, after the contrast can be seen in the bile duct a large number of irregular filling defects (Figure 4)Figure 3ERCP show duodenal nipple "fish eye signs" and accompanied by a large number of mucus outflow Figure 4 After the imaging see a large number of irregular filling defects in the biliary tube Spyglass examination shows that the bile tube under the small wall knots, a large number of mucosal coagulation and mucus in the bile tube, these mucous clots and mucus is caused by the cause of the deficiency The results of a wall nodule biopsy were confirmed to be a papilloma mucus tumor (IPMN) in the catheter with low-level epithelial endothelioma (Figure 5) Figure 5 Biopsy of nipple-like mucus-like tumors in the catheter is associated with low-level epithelial endosarcoma the causes of bile duct expansion include secondary bile duct stones, tumors or narrow bile duct obstruction, gallbladder excision, pancreatic bile duct malformation and congenital bile duct cysts In this case, bile duct expansion was caused by a build-up of mucus caused by nipple-like mucus tumors (IPMN of the bile duct, IPMN-B) in the bile duct, and bile duct stones in the liver may also be associated with IPMN-B similar to nipple-like mucus tumors (IPMN of the pancreas, IPMN-P) in the pancrea duct, IPMN-B also manifests itself as nipple-like and/or cystic lesions that secrete mucosin, and affects the intra-hepatic bile ducts and the hepatic bile ducts However, IPMN-B is rarer than IPMN-P and has a higher tendency to malignant transformation, so more aggressive surgical treatment is required when dealing with IPMN-B In summary, IPMN-B, as a special subtype in bile duct tumors, cannot be ignored in the differential diagnosis of bile duct expansion author's resume the first pan peng of
the first Pan Peng the of the , , a doctor of digestive medicine at Changhai Hospital
of the Naval Medical University, and the first author of the study was from Li Zhaoshen, a member of the General Author's institute, to (common) the first author in Gastroenter The journals of ology, Gut, JGH and other journals published 5 SCI papers, a single high if 20.8, participated in the writing and updating of 2 clinical guidelines in China, and was funded by the 2019 Doctoral Innovation Fund of the Naval Medical University professor
communications Assistant Director of Digestive Medicine, Associate Professor, Deputy Director physician, Master's Tutor, Chinese Digestive Society Youth Committee, Youth Committee of the Chinese Society of Digestive Society, National Outstanding Doctoral Thesis Recipient (2012), Deputy Editor of the Journal of Gastroenterology and Hepatology, Editorial Committee of the Chinese Digestive Journal, Chinese Digestive Endoscopy Journal, Chinese Journal of Gastroenterology, Gastroenterology, Shanghai, Shanghai Young Science and Technology Star, Shanghai Morning Light Scholar, Second Military Medical University Outstanding Young Scholar and Research Physician, Head of National Key Research and Development Program, chaired 4 National Natural Science Foundation , 5 Provincial and Ministerial Foundations; 20.8 cents Correspondent Li Zhaoshen Chinese Academy of Engineering, Professor, Chief Physician, Director of Digestive Medicine, Director of Digestive Medicine, Director of the National Digestive Medicine Clinical Medicine Research Center, Director of the National Digestive Endoscopy Center, Director of the National Digestive Medicine Institute, Director of shanghai Pancreatic Disease Research Institute, Executive Director of the Chinese Physicians Association, President of the Chinese Physicians Association Endoscopy Physicians Branch, Chairman of the Chinese Physicians Association, Chairman of the Chinese Association of Physicians, Former Chairman of the Chinese Society of Digestive Surgery Pan Peng, Bo Yu Li Zhaoshen Source: Digest