A Case Report of Amputation Neuroma of the Common Hepatic Duct Following Cholecystectomy

Amputation neuroma is not a true neoplasm but an overgrowth at transected stumps of the automonous nerve fibers. We have treated a patient with amputation neuroma which occurred in the common hepatic duct after cholecystectomy. A 63-year-old woman was hospitalized with complaints of epigastralgia and jaundice. She had undergone cholecystectomy eight years previously. Endoscopic retrograde cholangiopancreatography disclosed stenosis of the common hepatic duct with a smooth margin, and a common bile duct stone. On laparotomy, we found a tumor 7mm in diameter covered with normal mucosa on the right wall of the common hepatic duct. Enucleation of the tumor and choledochotomy with T-tube insertion were carried out. Postoperatively the stenotic segment was dilatedrepeatedly with a balloon catheter, and improved. Histologic examination revealed that the submucosal tumor was an amputation neuroma due to the previous surgery. Amputation neuroma is one of the causes of obstructive jaundice after cholecystectomy, and awareness of this entity will lead to accurate diagnosis avoiding unneccessary extensive operations.