THE DEVELOPMENT OF EXTRAHEPATIC PORTAL OBSTRUCTION AFTER UNDERGOING MULTIPLE OPERATIONS FOR A CONGENITAL DILATATION OF THE BILE-DUCT - REPORT OF A CASE

As a long-term complication after undergoing a cystenterostomy for a c ongenital dilatation of the bile duct, liver cirrhosis due to stenosis of the anastomosis or reflux cholangitis has been reported in conjunc tion with subsequent portal hypertension, We treated a 48-year-old Jap anese woman who developed both portal hypertension and pancytopenia af ter undergoing multiple operations for a congenital dilatation of the bile duct. She underwent a Hassab's operation in July 1994, when an oc clusion of the extrahepatic portal vein, which resulted in portal hype rtension, was first noted; the liver was microscopically normal. The e tiology of the extrahepatic portal obstruction in our patient was most likely due to either repeated inflammation or adhesion at the hepatic hilus. Based on these findings, the differential diagnosis of portal hypertension after an operation for a congenital dilatation of the bil e duct should therefore include an extrahepatic portal obstruction in addition to liver cirrhosis.