[Significant laparoscopy and ultrasound findings in chronic hepatic porphyria]

In the years from 1983 to 1989 we diagnosed in altogether 69 patients a chronic hepatic porphyria. As a rule the light microscopic and sonographic findings in the liver use to be uncharacteristic. Yet, unexpectedly by sonography in eight patients findings, suspicious for metastases, were stated. Multiple coin lesions with a marginal edge mostly rich in echoes were impressing. The laparoscopy resulted in grey/blue-discoloured depressions in an otherwise even surface of the liver, thus suggesting mass necroses respectively rebuilding processes. Subclinical stages of a chronic hepatic porphyria could have been proved by the partial red-fluorescence of bioptates and a corresponding porphyrin secretion. The histological changes of the liver were--in contrary to the impressing laparoscopic picture--rather insignificant. In case of a successful intervention the pathological porphyrin secretion was done in about eight months. Mostly, more than a year used to pass away till the sonographic findings normalized. The seldom described phenomena use to conceal the danger of a false interpretation and an unnecessary stress for the patient. More over the causes and the development of these peculiar porphyria findings are unclear; they need in an discussion among medical special branches.