Abstract
Changes of hepatic surface in various stages of Wilson's disease were discussed by peritoneoscopic examinations in 3 patients with Wilson's disease including cases of the sibling. Comparative studies were made on clinical and histological progress in the disease. Clinical and histological stages of these 3 patients were determined according to Deiss et all and Anderson et al. respectively. In the first case, 8 years old male with clinical stage 1, (hepatic copper accumulation), and precirrhotic stage histologically, peritoneoscopy showed yellowish and smooth liver surface similar to that of fatty liver. Biopsy specimen of the liver revealed typical fatty degeneration. The second case, 13 years old male and elder brother of case 1, with clinical stage JIB to III, (hepatic failure to cerebral copper accumulation), and partially arrested stage histologically, peritoneoscopy showed maculonodular postnecrotic liver cirrhosis. In the third case, 18 years old female, was in the clinical stage IIA to JIB, (hemolytic anemia to hepatic failure), and in the active stage histologically. Blue nodules, which were considered to be specific to Wilson's disease were found by peritoneoscopy. In these cases, peritoneoscopic findings correlated well to histological changes in progress of Wilson's disease.
