Portal vein phlebolithiasis found post-liver transplantation in the native liver of a child with biliary atresia.
Biliary atresia is defined as partial or total obliteration of the extra-hepatic bile ducts. In advanced cases, liver transplantation (LTx) is considered the most appropriate treatment. This report describes a female patient whose biliary atresia and subsequent cirrhosis required LTx at 1 yr of age. Macroscopic inspection of the hilar region of the native liver post-Tx revealed the formation of a pouch in the hepatic duct and a stone in the lumen of the portal vein. X-ray diffraction analysis showed that the stone was composed of cholesteryl cinnamate, gluconic acid phenylhydrazide, Na beta broma-allyl mercaptomethyl penicillinate, and Al2O3 crystals. While the cholesterol component is a known element of gallstones, we attributed the Na beta broma-allyl mercaptomethyl penicillinate to the patient's drug therapy. Our literature search revealed no previous record or crystallographic analysis of portal vein phlebolithiasis. In this report we describe this rare finding.
Department of Pathology, Baskent University, Ankara, Turkey. banubie@yahoo.com
B
B
Bilezikçi
B
B
Demirhan
H
H
Kiyici
M
M
Haberal
D001656:Biliary Atresia / Q000150:complications* / Q000473:pathology / Q000601:surgery; D002137:Calculi / Q000737:chemistry / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007565:Jaundice / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D011169:Portal Vein; D020246:Venous Thrombosis / Q000150:complications*