A Case of Right Hepatic Artery Syndrome Diagnosed by Using SpyGlassDSTM System

Yohei Takeda; Takumi Onoyama; Yuri Sakamoto; Shiho Kawahara; Wataru Hamamoto; Hiroki Koda; Taro Yamashita; Kazuya Matsumoto; Hajime Isomoto

doi:10.33160/yam.2020.11.010

Patient Report

A Case of Right Hepatic Artery Syndrome Diagnosed by Using SpyGlassDS^TM System

Yohei Takeda, Takumi Onoyama, Yuri Sakamoto, Shiho Kawahara, Wataru Hamamoto, Hiroki Koda, Taro Yamashita, Kazuya Matsumoto, Hajime Isomoto

Author information

Yohei Takeda
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Takumi Onoyama
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Yuri Sakamoto
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Shiho Kawahara
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Wataru Hamamoto
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Hiroki Koda
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Taro Yamashita
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Kazuya Matsumoto
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
Hajime Isomoto
Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan

Keywords: diagnostic imaging, extrahepatic cholestasis

JOURNAL FREE ACCESS

2020 Volume 63 Issue 4 Pages 372-375

DOI https://doi.org/10.33160/yam.2020.11.010

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Abstract

We report the case of a 68-year-old woman who had abdominal pain and slightly elevated biliary enzymes. Magnetic resonance cholangiopancreatography detected biliary duct stenosis, while contrast-enhanced magnetic resonance imaging showed that the right hepatic artery transversed the extrahepatic bile duct at the level of bifurcation of the bile duct. We performed endoscopic retrograde cholangiopancreatography and peroral cholangioscopy with the SpyGlass DS™ system. Then, mild extrinsic pulsatile compression of the bile duct was observed at stricture level with an intact bile duct epithelium. Therefore, she was diagnosed with right hepatic artery syndrome and underwent cholecystectomy. Six months later, her biliary enzyme level decreased, and the recurrence of pain gradually decreased.

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