Clinical Gastroenterology Vol.29 No.8(17)

Series
Title A Case of Nonalcoholic Steatohepatitis after Pancreaticoduodenectomy
Publish Date 2014/07
Author Yuji Kinoshita Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Akiyoshi Kinoshita Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Ken Tanaka Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Hiroshi Onoda Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Nami Imai Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Akira Iwaku Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Mutsumi Oishi Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Gou Kobayashi Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Hirohiko Kobayashi Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Nao Hushiya Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Syunichi Sakabe Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Hiroyuki Kijima Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Yoshinari Miyakawa Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Kazuhiko Koike Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Hirokazu Nishino Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
Author Tomoyoshi Okamoto Division of Hepato-Biliary-Pancreatic Surgery, The Jikei University Daisan Hospital
Author Hisao Tajiri Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine
[ Summary ] A 63-year-old female underwent pancreaticoduodenectomy (PD) under a diagnosis of early duodenal cancer and intraductal papillary mucinous adenoma in February 2011. Postoperatively, she developed fatigue and her liver transaminase levels were elevated (AST/ALT : 750/800). She was admitted to another hospital for an examination in July 2011. However, the cause of the abnormalities remained unknown, and the liver dysfunction subsequently persisted for two years. She was referred to our hospital for a further investigation in February 2013 and admitted to our department in June 2013. A liver biopsy specimen revealed macrovesicular steatosis, ballooning degeneration of hepatocytes, lobular inflammation and perivenular fibrosis, consistent with a diagnosis of nonalcoholic steatohepatitis (NASH). Under a diagnosis of NASH after PD, the patient received pancreatic enzyme replacement therapy, and her liver transaminase levels subsequently decreased. Although NASH after PD is relatively rare, clinicians should be aware of the presentation of the disease
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