BILE DUCTULAR CHOLESTASIS - AN OMINOUS HISTOPATHOLOGIC SIGN RELATED TO SEPSIS AND CHOLANGITIS LENTA
BILE DUCTULAR CHOLESTASIS - AN OMINOUS HISTOPATHOLOGIC SIGN RELATED TO SEPSIS AND CHOLANGITIS LENTA
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DOI：
10.1016/s0046-8177(82)80134-2
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发表时间：
1982-01-01
期刊：
影响因子：
3.3
通讯作者：
LEFKOWITCH, JH
中科院分区：
文献类型：
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作者：
LEFKOWITCH, JH
在3例患者的肝活检和尸检标本中发现一种罕见的肝内胆汁淤积症，表现为扩张和增殖的门静脉和门静脉周围胆管内的胆汁浓缩。临床表现以脓毒症和严重的全身性黄疸为主，未发现大范围胆管梗阻的尸检证据。这一病变可能与陈旧性胆管炎有关，这是一种慢性脓毒症，在没有明显外源性梗阻的情况下伴有胆道炎症。在肝活检标本中识别这种胆汁淤积模式对于某些患者是有用的，这些患者可能有很高的死亡风险，需要认真的临床关注，以阐明脓毒症的来源，以及积极处理其他全身疾病。在这种情况下，开腹手术将是没有回报的，并可能加速患者S的死亡。
An unusual form of intrahepatic cholestasis manifested by inspissated bile within dilated and proliferated portal and periportal bile ductules was seen in liver biopsy and autopsy specimens from 3 patients. Features of sepsis and severe systemic illness with jaundice dominated their clinical presentations, and no autopsy evidence of large bile duct obstruction could be found. This lesion may be related to the old entity, cholangitis lenta, a form of chronic sepsis associated with biliary tract inflammation in the absence of demonstrable extrinsic obstruction. Identification of this pattern of cholestasis in liver biopsy specimens is useful in certain patients who may be at great risk of mortality and who require serious clinical attention directed toward elucidating a source for sepsis as well as aggressive management of other systemic diseases. Laparotomy in such cases will be unrewarding and may hasten the patient''s demise.