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Case Report

Night Blindness Induced by Long-term External Bile Drainage

Seung Min Lee, Jin Young Choi, Ho Jun Kang, Ji Hee Sung, Sang Jong Park, Sun Hong Yoo, Young Min Park
The Ewha Medical Journal 2015;38(1):42-45. Published online: March 26, 2015

Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea.

Corresponding author: Sang Jong Park. Department of Internal Medicine, Bundang Jesaeng Hospital, 20 Seohyeon-ro, 180 beon-gil, Bundang-gu, Seongnam 463-774, Korea. Tel: 82-31-779-0207, Fax: 82-31-779-0929, elwind@daum.net
• Received: July 25, 2014   • Accepted: October 8, 2014

Copyright © 2015, The Ewha Medical Journal

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Vitamin A deficiency can occur as a result of malnutrition, malabsorption, or poor vitamin metabolism due to liver disease and night blindness might develop as the first symptom. Although there have been foreign reports about night blindness due to vitamin A deficiency which was derived from liver cirrhosis, primary biliary cirrhosis, intestinal bypass surgery or bariatric operation, it is hard to find reports about night blindness after percutaneous transhepatic biliary drainage for external bile drainage. We report a case of night blindness derived from fat-soluble vitamin A deficiency developed after long-term (18 months) external bile drainage for benign biliary stricture occurred after left hepatic lobectomy and hepaticojejunostomy due to the Klatskin tumor (IIIb). Her night blindness and low serum retinol level (0.02 mg/L) was dramatically improved after vitamin A supplementation. We recommend lipid-soluble vitamin supplementation on the case of long-term external bile drainage.
  • Keywords: Vitamin A deficiency; Night blindness; Percutaneous transhepatic biliary drainage
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Fig. 1

Magnetic resonance cholangiopancreatography 3 years after the operation. Severe stenosis is noticed at hepaticojejunostomy site (arrow).

emj-38-42-g001.jpg
Fig. 2

Percutaneous transhepatic biliary drainage is placed at the bile duct of posterior inferior segment (B6).

emj-38-42-g002.jpg
Fig. 3

Magnetic resonance cholangiopancreatograph (MRCP) 4 years after the operation. There is no change compared with the previous MRCP.

emj-38-42-g003.jpg

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      Night Blindness Induced by Long-term External Bile Drainage
      Ewha Med J. 2015;38(1):42-45.   Published online March 26, 2015
      DOI: https://doi.org/10.12771/emj.2015.38.1.42
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      Night Blindness Induced by Long-term External Bile Drainage
      Ewha Med J. 2015;38(1):42-45.   Published online March 26, 2015
      DOI: https://doi.org/10.12771/emj.2015.38.1.42
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      Night Blindness Induced by Long-term External Bile Drainage
      Image Image Image
      Fig. 1 Magnetic resonance cholangiopancreatography 3 years after the operation. Severe stenosis is noticed at hepaticojejunostomy site (arrow).
      Fig. 2 Percutaneous transhepatic biliary drainage is placed at the bile duct of posterior inferior segment (B6).
      Fig. 3 Magnetic resonance cholangiopancreatograph (MRCP) 4 years after the operation. There is no change compared with the previous MRCP.

      Fig. 1

      Fig. 2

      Fig. 3

      Night Blindness Induced by Long-term External Bile Drainage
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