A CASE OF LATENT CONGENITAL HEPATIC FIBROSIS WITH SPECIAL REFERENCE TO LAPAROSCOPIC FINDINGS

Abstract

Congenital hepatic fibrosis (CHF), with chief symptoms of portal hypertension and hepatomegaly, is a rare condition usually detected in infancy. We recently encountered a case of this condition, which had been asymptomatic before detection by abdominal ultrasonography. The patient was a 57-year-old man who was referred to our department after detection of a liver abnormality by abdominal ultrasonography during routine health check up. Repeat abdominal ultrasonography disclosed small scattered cystic lesions (about 1-5 mm in size) in both lobes of the liver. Abdominal CT revealed diffusely distributed small, low-density areas in the liver, which were not enhanced by contrast material. Laparoscopy disclosed numerous small black-green cysts (1-2 mm in diameter) on the liver surface. In addition, whitish markings were distinct in the portal region of the liver. Magnified Laparoscopy revealed branched whitish markings with a clear margin surrounding the hepatic lobules. This finding is specific for CHF. Therefore, laparoscopy was shown to be useful for diagnosis of CHF.