胆管系统肿瘤引起门脉高压的诊断及临床表现:两例报道并文献复习

Diagnosis and Manifestations of Portal Hypertension Caused by Biliary Tumors: Two Cases Report and Literature Review

目的总结分析胆管系统肿瘤引起门脉高压的诊断及临床表现,以期提高临床医师对本病的认识。方法回顾性分析2例胆管系统肿瘤患者的病史、临床表现及其引起门脉高压的特征,并综合文献复习。结果 2例胆管系统肿瘤分别为肝门部胆管癌及胆囊颈管癌,于术后半年至1年出现门脉高压,且临床表现不典型,分别以上消化道出血及腹痛为首发症状,并分别于发现门脉高压后6个月、2个月出现梗阻性黄疸,影像学检查提示肿瘤复发。结论胆管系统肿瘤是引起门脉高压的少见原因之一,应引起临床高度重视。且术后出现门脉高压表现高度提示肿瘤复发,预后不良。

Objective To review the clinical manifestations and diagnosis of portal hypertension caused by biliary tumors,to raise awareness about the disease among clinicians. Methods The medical history and clinical manifestations,and the features of biliary tumor - induced portal hypertension of two patients with biliary tumors were analyzed retrospectively,and the related literatures were reviewed. Results 2 patients had hilar bile duct carcinoma and the carcinoma of neck of gallbladder respectively,portal hypertension occurred half a year to one year after operation with atypical clinical feature. Abdominal pain and upper gastrointestinal hemorrhage were initial symptoms respectively. Obstructive jaundice occurred six months and two months after portal hypertension was found,respectively,and imageological examination results suggested tumor recurrence. Conclusion Biliary tumor is one of the rare reasons for portal hypertension,which should be paid much attention to in clinic. The occrurence of portal hypertension after operation highly suggests tumor recurrence and poor prognosis.