title: A case of Wilson's disease with characteristic laparoscopic findings.
abstract: A 44-year-old male was pointed out liver function abnormality by medical check-up. Blood examination and computed tomography showed liver cirrhosis. Then, he was referred to our hospital for further examination. After blood test, viral markers revealed previous infection of hepatitis B virus (HBV). We estimated the etiology of his liver disease as previous HBV infection. On laparoscopic examination, his liver surface was nodular with mixed yellowish nodules and ash gray to copper-colored nodules in the diameter of 3-10 mm. There were large regenerative nodules in segments 3 and 4. Large regenerative nodules and irregular steatosis were contradictory to HBV-related liver cirrhosis, so then we supposed Wilson's disease. The amount of copper excretion in the urine was 326.6 μg (>100 μg/24 h). After D-penicillamine administration, urinary copper excretion increased to 2151.5 μg/24 h. Though hepatic copper concentration was 174.5 μg/g wet tissue (>200 μg/g wet tissue), his laboratory data fulfilled the Leipzig diagnostic criteria proposed by EASL. Laparoscopic examination with liver biopsy has advantages to survey many disease-specific findings on liver surface and to obtain adequate liver sample. Laparoscopic examination is one of the effective procedures for diagnosing relatively rare liver disease like Wilson's disease.
authors.affiliation: Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan, shinm0416@yahoo.co.jp.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Muro
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yasunaka
authors.forename: Nozomu
authors.initials: N
authors.lastname: Wada
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Fusao
authors.initials: F
authors.lastname: Ikeda
authors.forename: Hidenori
authors.initials: H
authors.lastname: Shiraha
authors.forename: Akinobu
authors.initials: A
authors.lastname: Takaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Noso
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Iwasaki
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D006527:Hepatolenticular Degeneration / Q000473:pathology*; D006801:Humans; D010535:Laparoscopy; D008297:Male