Abstract
This is a report on a case of woman to whom 11-year surveillance through Percutaneous Transhepatic Cholangiodrainage (PTCD) was performed. A 43-year old woman manifesting brown urine and systemic pruritis was introduced in 1985. Diagnosis was obstructive jaundice leading to performing PTCD. Cholangiography revealed a stenotic area extended to the second branch of the hepatic ducts confluence. We applied a catheter toward the peripheral hepatic duct by U-turn. Suspecting primary sclerosing cholangitis, we improved and maintained general conditions of the case through reinforcing and improving catheter resiliency, which eased distention of the duct.
When she left hospital, the total bilirubin value was 1.9 mg/dl that was 24 mg/dlbefore PTCD. For 10 years, no serious hepatic malfunction like jaundice occurred and catheter trouble was experienced. In April 1997, she got fever and jaundice then died of suppurative cholangitis and liver abscess in June. Autopsy revealed a severe stenosis around the hepatic ducts confluence and histopathology demonstrated amputation neuroma. This is interesting out of 54 cases reported, from the standpoint of lesion development modality and limit of drainage application to a nonoperable cases.
