中瀬 一則¹, 伊藤 質¹, 宮木 良生², 津田 雅之³

Kazunori NAKASE¹, Tadasu ITO¹, Yoshio MIYAGI², Masayuki TSUDA³

¹山田赤十字病院内科, ²山田赤十字病院放射線科, ³三重大学医学部第二内科

¹Department of Internal Medicine, Yamada Red Cross Hospital, ²Department of Radiology, Yamada Red Cross Hospital, ³The Second Department of Internal Medicine, Mie University School of Medicine

キーワード : Cholelithiasis, Fulminant hepatitis, Calcium phosphate, Childhood

　A male, 1 1/4 year-old, admitted to our hospital because of eyelid edema and hepatomegaly. His serum transaminase level was markedly increased and he was diagnosed acute hepatitis non A non B based on his viral marker study. On follow up observation using ultrasound, atrophy and wall thickening of the gall bladder were found and incidentally the process of gall stone formation was demonstrated. He became rapidly icteric and lapsed into coma. He died seventeen days after admission despite of our intensive treatment. At autopsy, a calcium phosphate gall stone was demonstrated. The liver showed massive hemorrhagic necrosis. Marked subserosal edema was seen in the gall bladder wall. It is very useful for ultrasonic examination to study the biliary system in hepatitis.