Korean J Pancreas Biliary Tract.  2015 Apr;20(2):105-110. 10.15279/kpba.2015.20.2.105.

A Case of Combined Congenital Hepatic Fibrosis and Biliary Hamartoma Presented with Recurrent Acute Cholangitis

• Kim KB
• Ji MJ
• Yang JY
• Han JH
• Chae HB
• Park SM
• Kang MH
• Sung R
• Youn SJ

• KMID: 2448483
• DOI: http://doi.org/10.15279/kpba.2015.20.2.105

Abstract

Biliary hamartoma and congenital hepatic fibrosis belong to fibrocystic disorders originating from ductal plate malformation. A 66-year-old man who had incidentally been diagnosed with biliary hamartoma two years ago presented to us with recurrent acute cholangitis. In the first episode, he had presented with septic shock and was treated with endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy under the diagnosis of acute cholecystitis and cholangitis. However, during a two-month follow-up period, the patient experienced four episodes of acute cholangitis. Because he showed normal ERCP, and biliary hamartoma is usually asymptomatic, a liver biopsy was performed. Pathology revealed combined features of biliary hamartoma and congenital hepatic fibrosis, characterized as periportal fibrosis and intrahepatic ductular dysplasia. During follow-up for the last six months, he had experienced two episodes of acute cholangitis and was treated with antibiotics. A follow-up abdominal CT scan revealed aggravated hepatosplenomegaly compared to that of two years ago. We report a case of combined congenital hepatic fibrosis and biliary hamartoma and a literature review.

Keyword

Biliary hamartoma; Congenital hepatic fibrosis; Recurrent acute cholangitis

MeSH Terms

Aged
Anti-Bacterial Agents
Biopsy
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis*
Cholecystectomy
Cholecystitis, Acute
Diagnosis
Fibrosis*
Follow-Up Studies
Hamartoma*
Humans
Liver
Pathology
Shock, Septic
Tomography, X-Ray Computed
Anti-Bacterial Agents