title: Traumatic Neuroma Causing Biliary Stricture After Orthotopic Liver Transplant, Treated With Hepaticojejunostomy: A Case Report.
abstract: Traumatic neuromas of the biliary tract have occasionally been reported to cause strictures at the cystic duct stump as a late complication of cholecystectomy with common bile duct exploration. The incidence of symptomatic traumatic biliary neuroma appears to be low after orthotopic liver transplant, as only 25 patients have been described previously in the English-language literature. Traumatic (amputation) neuroma is a reactive proliferation of pericholangial nerve fibers induced by injury, but it is not a true neoplasm. The diagnosis of traumatic neuroma is possible only by histopathologic examination; the diagnostic finding is a mass of hyperplastic nerve bundles. We report a patient with a traumatic neuroma causing an early biliary stricture with intrahepatic extension after an orthotopic liver transplant. The lesion failed to respond to repeated endoscopic stenting and eventually required hepaticojejunostomy. A biopsy of the liver graft, performed in the 13th month after transplant, showed chronic ductopenic rejection.
authors.affiliation: Department of Pathology and Laboratory Medicine, Baskent University, Ankara, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Terzi
authors.forename: Mahir
authors.initials: M
authors.lastname: Kirnap
authors.forename: Cigdem
authors.initials: C
authors.lastname: Sercan
authors.forename: Gokce
authors.initials: G
authors.lastname: Ozdemir
authors.forename: Binnaz Handan
authors.initials: BH
authors.lastname: Ozdemir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000293:Adolescent; D001661:Biliary Tract Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001706:Biopsy; D002758:Cholangiography; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002908:Chronic Disease; D003251:Constriction, Pathologic; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D016031:Liver Transplantation / Q000009:adverse effects*; D009463:Neuroma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome