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英文誌(2004-)

Journal of Medical Ultrasonics

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1986 - Vol.13

Vol.13 No.03

Case Report(症例報告)

(0191 - 0196)

劇症肝炎の経過中に腹部超音波検査にて胆石が発見された1幼児例

Ultrasonic Diagnosis of Cholelithiasis Associated with Fulminant Hepatitis in Childhood

中瀬 一則1, 伊藤 質1, 宮木 良生2, 津田 雅之3

Kazunori NAKASE1, Tadasu ITO1, Yoshio MIYAGI2, Masayuki TSUDA3

1山田赤十字病院内科, 2山田赤十字病院放射線科, 3三重大学医学部第二内科

1Department of Internal Medicine, Yamada Red Cross Hospital, 2Department of Radiology, Yamada Red Cross Hospital, 3The Second Department of Internal Medicine, Mie University School of Medicine

キーワード : Cholelithiasis, Fulminant hepatitis, Calcium phosphate, Childhood

 A male, 1 1/4 year-old, admitted to our hospital because of eyelid edema and hepatomegaly. His serum transaminase level was markedly increased and he was diagnosed acute hepatitis non A non B based on his viral marker study. On follow up observation using ultrasound, atrophy and wall thickening of the gall bladder were found and incidentally the process of gall stone formation was demonstrated. He became rapidly icteric and lapsed into coma. He died seventeen days after admission despite of our intensive treatment. At autopsy, a calcium phosphate gall stone was demonstrated. The liver showed massive hemorrhagic necrosis. Marked subserosal edema was seen in the gall bladder wall. It is very useful for ultrasonic examination to study the biliary system in hepatitis.