Abstract
Diagnosis of cholangiocarcinoma is best accomplished with ultrasound, magnetic resonance cholangiography and endoscopic retrograde cholangiography. In this case, the carcinoma was seen in magnetic resonance imaging and in contrast enhanced ultrasound as a malperfusion of the left liver lobe. One possible reason of this phenomenon could be that the carcinoma at the time of diagnosis had already advanced very far. Only histological examination of the liver biopsy showed the cholangiocarcinoma.
Zusammenfassung
Für die Diagnosestellung cholangiozellulärer Karzinome stellen die abdominelle Sonographie, die Magnetresonanzcholangiographie und die endoskopisch retrograde Cholangiographie den Goldstandard dar. In dieser Kasuistik erfolgte bei Verdacht auf dekompensierte Leberzirrhose mit hepatorenalem Syndrom primär die Einweisung des Patienten auf die Intensivstation. Das anfangs nicht bekannte Gallengangskarzinom war zum Zeitpunkt der Diagnosestellung so weit fortgeschritten, dass es sich zunächst in der kontrastmittel- gestützten Sonographie und der Magnetresonanztomographie als eine Malperfusion des linken Leberlappens bei bekannter Leberzirrhose darstellte. Erst die histologische Untersuchung des Leberbiopsates erbrachte das Ergebnis eines cholangiozellulären Karzinoms.
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Zierhut, S., Schlottmann, K. & Wrede, C. Ungewöhnliche Präsentation eines cholangiozellulären Karzinoms als Grund eines Leberversagens. Intensivmed 44, 43–49 (2007). https://doi.org/10.1007/s00390-006-0695-0
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DOI: https://doi.org/10.1007/s00390-006-0695-0