PORTAL-VEIN OBSTRUCTION ACCOMPANIED BY INTRAHEPATIC STONES

This study was conducted to clarify the pathogenesis of portal vein ob struction (PVO) associated with intrahepatic stones. Five cases with P VO and intrahepatic stones were studied retrospectively. The coinciden ce rate of PVO in intrahepatic stones was 5.8% (5 of 86 cases), and th at of intrahepatic stones in WO, 45.5% (5 of 11 cases). All cases had one or more symptoms of cholangitis, such as high-grade fever, abdomin al pain, and jaundice prior to diagnosis of PVO. The portal vein was o ccluded at the main trunk in 4 and in the left branch in 1. Intrahepat ic stones were found in bilateral hepatic lobes in 3 and in the left l obe in 2. Numerous calcium bilirubinate stones were packed in dilatate d intrahepatic bile ducts of an excised specimen of the liver. Microsc opically, arterial structures could be seen, but the portal vein cease d to be evident about the involved bile duct. Based on the results of this study, persistent cholangitis and packed gallstones were conclude d essential to the development of PVO accompanied by intrahepatic ston es.