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To the Editor Obstructive jaundice by vascular compression is extremely rare. Luttwak and Schwartz first described jaundice due to an obstruction of the common hepatic duct by an aberrant artery. Compression of extrahepatic bile duct (EBD) by right hepatic artery was defined as right hepatic artery syndrome. We present here a rare case of asymptomatic biliary obstruction due to compression of the common bile duct by right hepatic artery. A 74-year-old female presented with slight epigastric pain. Her past medical history and physical examination were unremarkable. On laboratory examination, alkaline phosphatase, gamma-glutamyl transpeptidase, total biluribin, aspartate aminotransferase and alanine aminotransferase were normal. Ultrasonography revealed moderate dilatation of common bile duct and intrahepatic ducts. Abdominal computerized tomography (CT) showed compression from the dorsum and stenosis of the EBD by the right hepatic artery, but did not reveal a mass or lymph node swelling around EBD. Proximal and distal choleduct was 9.7 mm and 6.8 mm, respectively. MRCP showed a stenotic lesion at the level of the upper common hepatic duct. Hepatic artery was normal at CT angiography. Since she was asymptomatic, we decided on regularly follow-up in the out-patient.

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2011-11-29   |   1,143 visitas   |   Evalua este artículo 0 valoraciones

Vol. 11 Núm.1. Enero-Febrero 2012 Pags. 150-151 Ann Hepatol 2012; 11(1)