Abstract
A 58-year-old female was referred to our hospital from a nearby physician because of impaired liver function. Blood analysis revealed a slightly elevated level of transaminase. Abdominal CT scan revealed wall thickening of the middle and lower bile duct. MRCP and percutaneous transhepatic cholangiography revealed stenosis of the middle and lower bile duct. The stenosis was seen to taper off. Bile duct cancer was suspected and pancreatoduodenectomy was performed. The resected specimen showed black bilirubin pigment deposited to the mucosa of the narrowed lesion and wall thickening of the bile duct. Histopathology showed no malignancy but revealed findings of cholangitis with necrosis affecting the full thickness of the bile duct. In addition, there were no findings of primary sclerosing cholangitis and IgG4 positive cholangitis. In this paper, we report a case of inflammatory sclerosing biliary stricture from unknown origin, which needed differentiation from bile duct cancer.
