Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2022; 28(30): 4211-4220
Published online Aug 14, 2022. doi: 10.3748/wjg.v28.i30.4211
Contrast-enhanced ultrasound of a traumatic neuroma of the extrahepatic bile duct: A case report and review of literature
Zhi-Qiang Yuan, Hua-Lin Yan, Jia-Wu Li, Yan Luo
Zhi-Qiang Yuan, Hua-Lin Yan, Jia-Wu Li, Yan Luo, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Yuan ZQ performed the literature review and wrote the manuscript; Yan HL and Li JW supported the data collection and manuscript revision; Luo Y supervised the writing and revision of the manuscript; all authors read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 82071940.
Informed consent statement: Written informed consent for publication was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Luo, Doctor, Professor, Department of Medical Ultrasound, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. yanluo@scu.edu.cn
Received: February 10, 2022
Peer-review started: February 10, 2022
First decision: April 5, 2022
Revised: April 17, 2022
Accepted: July 16, 2022
Article in press: July 16, 2022
Published online: August 14, 2022
Processing time: 180 Days and 23.4 Hours
Abstract
BACKGROUND

Traumatic neuromas result from nerve injury after trauma or surgery but rarely occur in the bile duct. However, it is challenging to diagnose traumatic neuromas correctly preoperatively. Although some previous reports have described the imaging features of traumatic neuroma in the bile duct, no features of traumatic neuromas in the bile duct have been identified by using contrast-enhanced ultrasound (CEUS) imaging before.

CASE SUMMARY

A 55-year-old male patient presented to our hospital with a 3-mo history of abdominal distension and anorexia and history of cholecystectomy 4 years ago. Grayscale ultrasound demonstrated mild to moderate intrahepatic bile duct dilatation. Meanwhile, a hyperechoic nodule was found in the upper extrahepatic bile duct. The lesion approximately 0.8 cm × 0.6 cm with a regular shape and clear margins. The nodule of the bile duct showed slight hyperenhancement in the arterial phase and isoenhancement in the venous phase on CEUS. Laboratory tests showed that alanine aminotransferase and aspartate aminotransferase were increased significantly, while the tumor marker carbohydrate antigen 19-9 was increased slightly. Then, hilar bile duct resection and end-to-end bile ductal anastomosis were performed. The histological examination revealed traumatic neuroma of the extrahepatic bile duct. The patient had an uneventful recovery after surgery.

CONCLUSION

The current report will help enhance the current knowledge regarding identifying traumatic neuromas by CEUS imaging and review the related literature.

Keywords: Traumatic neuroma; Bile duct; Contrast-enhanced ultrasound; Enhancement; Cholangiocarcinoma; Case report

Core Tip: A traumatic neuroma results from nerve injury after trauma or surgery but rarely occurs in the bile duct. Herein, we present some of the sonographic features of ultrasound and contrast-enhanced ultrasound in a case of a traumatic neuroma. We report this unusual case and review the related literature to improve the diagnosis and differential diagnosis of a traumatic neuroma of the bile duct and related imaging findings.