Unusual presentation of a low-grade intraductal papillary neoplasm of the bile duct

Publication date: Available online 31 March 2015 Source:Formosan Journal of Surgery Author(s): Kian-Hwee Chong , Chao-Chuan Wu , Chia-Chi Wang , Yi-Hsin Lee , Yao-Jen Chang , Sen-Chang Yu Intraductal papillary neoplasm of the bile duct usually manifests as abdominal pain, jaundice, and cholangitis but rarely presents as hemobilia. In this article, we present the case of a 74-year-old man with a 2-year history of repeated hemobilia without a definite diagnosis. A cholangiogram revealed a left intrahepatic duct dilatation with a filling defect, and computed tomography revealed a hyperdense lesion in the left lateral liver segment, which was subsequently resected. Histopathological examination revealed focal low-grade intraductal papillary neoplasm of the bile duct and markedly dilated bile ducts with a ruptured blood vessel. The postoperative course was uneventful. Clinicians should comprehensively evaluate cases of unusual and recurrent gastrointestinal bleeding by considering this diagnosis.
Source: Formosan Journal of Surgery - Category: Surgery Source Type: research