A case of Wilson’s disease with characteristic laparoscopic findings
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- 作者：Shin-ichiro Muro (1)
Tetsuya Yasunaka (1)
Nozomu Wada (1)
Yuki Morimoto (1)
Fusao Ikeda (1) (2)
Hidenori Shiraha (1)
Akinobu Takaki (1)
Kazuhiro Noso (1) (2)
Hiroaki Iwasaki (3)
Kazuhide Yamamoto (1) - 关键词：Wilson’s disease ; Laparoscopy ; Liver cirrhosis
- 刊名：Clinical Journal of Gastroenterology
- 出版年：2014
- 出版时间：April 2014
- 年：2014
- 卷：7
- 期：2
- 页码：175-179
- 全文大小：739 KB
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Tetsuya Yasunaka (1)
Nozomu Wada (1)
Yuki Morimoto (1)
Fusao Ikeda (1) (2)
Hidenori Shiraha (1)
Akinobu Takaki (1)
Kazuhiro Noso (1) (2)
Hiroaki Iwasaki (3)
Kazuhide Yamamoto (1)
1. Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
2. Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
3. Health Service Center, Okayama University, Okayama, Japan - ISSN：1865-7265
文摘
A 44-year-old male was pointed out liver function abnormality by medical check-up. Blood examination and computed tomography showed liver cirrhosis. Then, he was referred to our hospital for further examination. After blood test, viral markers revealed previous infection of hepatitis B virus (HBV). We estimated the etiology of his liver disease as previous HBV infection. On laparoscopic examination, his liver surface was nodular with mixed yellowish nodules and ash gray to copper-colored nodules in the diameter of 3-0?mm. There were large regenerative nodules in segments 3 and 4. Large regenerative nodules and irregular steatosis were contradictory to HBV-related liver cirrhosis, so then we supposed Wilson’s disease. The amount of copper excretion in the urine was 326.6?μg (>100?μg/24 h). After D-penicillamine administration, urinary copper excretion increased to 2151.5?μg/24 h. Though hepatic copper concentration was 174.5?μg/g wet tissue (>200?μg/g wet tissue), his laboratory data fulfilled the Leipzig diagnostic criteria proposed by EASL. Laparoscopic examination with liver biopsy has advantages to survey many disease-specific findings on liver surface and to obtain adequate liver sample. Laparoscopic examination is one of the effective procedures for diagnosing relatively rare liver disease like Wilson’s disease.