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Obstructive jaundice

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https://www.readbyqxmd.com/read/28220692/diagnostic-approach-using-ercp-guided-transpapillary-forceps-biopsy-or-eus-guided-fine-needle-aspiration-biopsy-according-to-the-nature-of-stricture-segment-for-patients-with-suspected-malignant-biliary-stricture
#1
Yun Nah Lee, Jong Ho Moon, Hyun Jong Choi, Hee Kyung Kim, Seo-Youn Choi, Moon Han Choi, Tae Hee Lee, Tae Hoon Lee, Sang-Woo Cha, Sang-Heum Park
In malignant biliary stricture (MBS), the diagnostic accuracy of ERCP-based tissue sampling is insufficient. EUS-guided fine needle aspiration biopsy (EUS-FNAB) is emerging as a reliable diagnostic procedure. This study aimed to evaluate the usefulness of a diagnostic approach using ERCP-guided transpapillary forceps biopsy (TPB) or EUS-FNAB according to the characteristics of suspected MBS. Consecutive patients diagnosed with suspected MBS with obstructive jaundice and/or cholangitis were enrolled prospectively...
February 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28216982/late-onset-severe-biliary-bleeding-after-endoscopic-pigtail-plastic-stent-insertion
#2
Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Takaaki Ito, Hiroyuki Morishita, Norimasa Yoshida
Here, we report our experience with a case of severe biliary bleeding due to a hepatic arterial pseudoaneurysm that had developed 1 year after endoscopic biliary plastic stent insertion. The patient, a 78-year-old woman, presented with hematemesis and obstructive jaundice. Ruptured hepatic arterial pseudoaneurysm was diagnosed, which was suspected to have been caused by long-term placement of an endoscopic retrograde biliary drainage (ERBD) stent. This episode of biliary bleeding was successfully treated by transarterial embolization (TAE)...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28213744/intraductal-papillary-neoplasm-originating-from-an-anomalous-bile-duct
#3
Harufumi Maki, Taku Aoki, Takeaki Ishizawa, Mariko Tanaka, Takashi Sakatani, Yoshifumi Beck, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified...
February 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28205184/extrahepatic-bile-duct-hepatocellular-carcinoma-due-to-recurrence-of-hematogenous-metastasis-50%C3%A2-months-after-hepatectomy
#4
Hiroyuki Kumata, Shigehito Miyagi, Keigo Murakami, Atsushi Fujio, Yasuyuki Hara, Chikashi Nakanishi, Naoki Kawagishi, Hironobu Sasano, Takashi Kamei, Noriaki Ouchi
BACKGROUND: Recurrent hepatocellular carcinoma (HCC) in the extrahepatic bile duct is rare with most cases diagnosed after manifesting sudden obstructive jaundice. Here, we report an extremely rare case of recurrent HCC in the common bile duct due to hematogenous metastasis. CASE PRESENTATION: A 66-year-old man underwent an extended left hepatectomy for HCC in the medial segment of the liver. Fifty months later, he presented with sudden obstructive jaundice. Endoscopic retrograde cholangiography showed a space-occupying lesion in the common bile duct, which was suspected as cholangiocarcinoma...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28205125/does-hyperbilirubinemia-contribute-to-adverse-patient-outcomes-following-pancreatoduodenectomy
#5
Scott Dolejs, Ben L Zarzaur, Nicholas J Zyromski, Henry A Pitt, Taylor S Riall, Bruce L Hall, Stephen W Behrman
BACKGROUND: Jaundice due to biliary obstruction leads to multiple physiologic derangements and a decline in performance status that may result in unfavorable intra- and postoperative outcomes following a Whipple procedure. While preoperative biliary decompression may improve synthetic function, this strategy has been reported to increase the incidence of infectious complications following surgery. We hypothesized that hyperbilirubinemia at the time of pancreatoduodenectomy (PD) would be a risk factor for increased morbidity and mortality postoperatively...
February 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28203125/migration-of-surgical-clips-into-the-common-bile-duct-after-laparoscopic-cholecystectomy
#6
Krishn Kant Rawal
Laparoscopic cholecystectomy (LC) is currently the treatment of choice for symptomatic gallstones. Associated complications include bile duct injury, retained common bile duct (CBD) stones, and migration of surgical clips. Clip migration into the CBD can present with recurrent cholangitis over a period of time. Retained CBD stones can be another cause of recurrent cholangitis. A case of two surgical clips migrating into the common bile duct with few retained stones following LC is reported here. The patient had repeated episodes of fever, pain at epigastrium, jaundice, and pruritus 3 months after LC...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28202062/isolated-igg4-related-sclerosing-cholangitis-misdiagnosed-as-malignancy-in-an-area-with-endemic-cholangiocarcinoma-a-case-report
#7
Narongsak Rungsakulkij, Pattana Sornmayura, Penampai Tannaphai
BACKGROUND: The most common cause of perihilar obstruction is cholangiocarcinoma, especially in Thailand. Benign perihilar stricture represents less than 20% of cases. IgG4-related disease and IgG4-related sclerosing cholangitis, however, have been receiving increased recognition. Isolated IgG4-related sclerosing cholangitis is less common. The preoperative diagnosis of IgG4-related sclerosing cholangitis without pancreatic involvement is very difficult because the clinical presentation and preoperative evaluation are extremely difficult to distinguish from perihilar cholangiocarcinoma...
February 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28197205/from-pathogenesis-clinical-manifestation-and-diagnosis-to-treatment-an-overview-on-autoimmune-pancreatitis
#8
REVIEW
Ou Cai, Shiyun Tan
Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis which is autoimmune mediated. The international consensus diagnostic criteria (ICDC) 2011 proposed two types of AIP: type I is associated with histological pattern of lymphoplasmacytic sclerosing pancreatitis (LPSP), characterized by serum IgG4 elevation, whereas type 2 is named idiopathic duct-centric pancreatitis (IDCP), with granulocytic epithelial lesion (GEL) and immunoglobulin G4 (IgG4) negative. The pathogenic mechanism is unclear now; based on genetic factors, disease specific or related antigens, innate and adaptive immunity may be involved...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28190362/unusual-presentation-of-obstructive-jaundice
#9
Alejandra Gordillo Hernández, Ángel Nogales Muñoz, Fernando Oliva Mompeán
Carcinoid tumors of the ampulla of Vater grow slowly and have an excellent prognosis after complete resection of local disease. Histopathological diagnosis is definitive, and the Whipple's procedure is performed as a standard at the present time, although more novel minimally-invasive techniques may be highly useful for selected patients. While tumor size is not a reliable marker of tumor aggression, it is nonetheless related to lymphatic invasion, hence an accurate diagnosis is important if the patient is to be offered the best option available for the treatment of their disease...
February 13, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28179982/spontaneous-biloma-due-to-an-intrahepatic-cholangiocarcinoma-an-extremely-rare-case-report-with-long-term-survival-and-literature-review
#10
Georgios K Georgiou, Athina Tsili, Anna Batistatou, Alexandra Papoudou-Bai, Georgios Papadopoulos, Michalis Fatouros, Georgios K Glantzounis
Cholangiocarcinomas are tumors that arise from the ductal epithelium of the intrahepatic or extra-hepatic bile ducts. Patients are usually asymptomatic or may present with weight loss, fatigue, loss of appetite and abdominal pain (intrahepatic cholangiocarcinomas) or jaundice (extra-hepatic cholangiocarcinomas). Subcapsular bile vessel rupture, due to intrahepatic cholangiocarcinoma, is an extremely rare clinical presentation, which is an emergent and potentially life-threatening complication. We report the case of a 79-year-old female patient suffering from an intrahepatic cholangiocarcinoma that completely obliterated the left main hepatic duct...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28169486/hepatic-vena-cava-syndrome-new-concept-of-pathogenesis
#11
REVIEW
Santosh Man Shrestha, Masayoshi Kage, Byung Boong Lee
Hepatic vena cava syndrome (HVCS) also known as membranous obstruction of inferior vena cava was considered a rare congenital disease and included under Budd Chiari syndrome. It is now recognized as a bacterial infection induced disease related to poor hygienic living condition. Localized thrombophlebitis of IVC at the site close to hepatic veins (HV) outlets is the initial lesion which converts on resolution into stenosis or complete obstruction, the circulatory equilibrium being maintained by development of cavo-caval collateral anastomosis...
February 7, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28169138/outcomes-of-salvage-percutaneous-biliary-drainage-after-occlusion-of-endoscopic-stents
#12
Jonathan Kessler, Aram Lee, Paul Frankel, Andrew Dagis, John J Park, James Lin
PURPOSE: To describe outcomes of patients with malignant biliary obstruction who undergo salvage percutaneous biliary drainage after occlusion of endoscopic biliary stents. MATERIALS AND METHODS: A single-center retrospective review was performed of 47 patients (25 men, 22 women) who underwent percutaneous biliary drainage for recurrent obstruction after endoscopic stent placement between 2005 and 2015. Primary malignancies were bile duct (n = 13), colorectal (n = 11), gallbladder (n = 7), pancreas (n = 5), hepatocellular (n = 4), and other (n = 7)...
February 3, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28162906/comparative-study-of-percutaneous-transhepatic-biliary-stent-placement-with-or-without-iodine-125-seeds-for-treating-patients-with-malignant-biliary-obstruction
#13
Asihaer Hasimu, Jun-Peng Gu, Wei-Zheng Ji, Hai-Xiao Zhang, Di-Wen Zhu, Wei-Xin Ren
PURPOSE: To prospectively evaluate safety and efficacy of biliary stent placement with iodine-125 ((125)I) seeds in patients with malignant obstructive jaundice (MOJ). MATERIALS AND METHODS: From July 2011 to June 2014, 55 patients were enrolled (group A, 11 men and 17 women, mean age 70.93 y ± 8.58; group B, 14 men and 13 women, mean age 70.26 y ± 9.71). All patients were randomly assigned to placement of a biliary stent with (125)I seeds (group A) or biliary stent only (group B)...
February 2, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28145671/evaluation-of-jaundice-in-adults
#14
Matthew V Fargo, Scott P Grogan, Aaron Saguil
Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include fractionated bilirubin, a complete blood count, alanine transaminase, aspartate transaminase, alkaline phosphatase, ?-glutamyltransferase, prothrombin time and/or international normalized ratio, albumin, and protein. Imaging with ultrasonography or computed tomography can differentiate between extrahepatic obstructive and intrahepatic parenchymal disorders...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28143989/mortality-related-factors-in-patients-with-malignant-obstructive-jaundice
#15
Juferdy Kurniawan, Irsan Hasan, Rino Alvani Gani, Marcellus Simadibrata
AIM: to obtain survival rate and mortality-related factors of malignant obstructive jaundice patients. METHODS: all medical records of obstructive jaundice inpatient at Cipto Mangunkusumo Hospital, Jakarta from January 2010 to December 2013 were reviewed retrospectively. The following factors were analyzed in terms of mortality: age, gender, sepsis, hypoalbumin, serum bilirubin level, serum CA 19-9 level, billiary drainage, non-ampulla Vateri carcinoma, and comorbid factors...
October 2016: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28133338/-a-case-of-axillary-lymph-node-metastases-from-distal-bile-duct-cancer
#16
Makoto Muto, Takashi Kimura, Naoya Sato, Junichiro Watanabe, Kotaro Endo, Shigeru Marubashi, Akira Kenjo, Mitsukazu Gotoh
A 67-year-old man suffered from obstructive jaundice due to distal bile duct cancer. He underwent surgery after percutaneous biliary drainage and did not received adjuvant chemotherapy afterwards. Two years after surgery, some subcutaneous nodules were detected in the left axilla and the lateral chest on enhanced CT imaging. The nodules were diagnosed as metachronous distant metastases from bile duct cancer based on pathological findings. He was treated postoperatively with S-1 and new lesions have not been detected during the 3 months after the surgery...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133234/-a-case-of-primary-sclerosing-cholangitis-difficult-to-distinguish-from-a-hilar-cholangiocarcinoma
#17
Yutaka Umehara, Minoru Umehara, Shinji Tsutsumi, Akitoshi Kimura, Tomohisa Tokura, Kenichi Takahashi, Takayuki Morita
A 78-year-old man, who had presented with onset of ulcerative colitis at the age of 56 years and had been in remission for the past several years, attended our hospital with a diagnosis of obstructive jaundice. A hilar cholangiocarcinoma with right hepatic artery invasion was suspected on contrast enhanced CT. An endoscopic retrograde cholangiography indicated Bismuth type 2 stenosis. The stenotic bile duct brushings revealed no malignancy. Primary sclerosing cholangitis(PSC)and IgG4- related cholangitis were included in the differential diagnosis; however, a significant result could not be obtained in any other examinations...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133228/-a-case-of-liver-metastasis-of-ampullary-carcinoma-that-developed-postoperatively-that-was-effectively-treated-with-gemcitabine-plus-cisplatin
#18
Yasuaki Miyazaki, Kazuo Yamabe, Nobuyasu Hayashi, Toshiya Michiura, Tomo Nakagawa, Keita Okubo, Shigeo Fujita, Makio Nagaoka
A 75-year-oldman presenting with obstructive jaundice was referredto our hospital. Basedon a diagnosis of carcinoma of the ampulla of Vater, we performed pancreatoduodenectomy. Postoperative histopathological examination revealed a welldifferentiated papillotubular adenocarcinoma, T3, N0, M0, Stage III . Six months after surgery, an isolatedliver metastasis in S6 was identifiedon CT scan andMRI; therefore, we administeredgemcitabine plus cisplatin chemotherapy. After 6 courses of this regimen, a clinical complete response(CR)was obtained...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133227/-resection-for-a-locally-advanced-duodenal-adenocarcinoma-with-obstructive-jaundice-and-hepatic-and-pancreatic-invasion-a-case-report
#19
Yuki Hirose, Jun Sakata, Daiki Soma, Tomohiro Katada, Hirosuke Ishikawa, Kohei Miura, Taku Ohashi, Kazuyasu Takizawa, Kabuto Takano, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai
A 64-year-old woman diagnosed with duodenal adenocarcinoma with duodenal stenosis and obstructive jaundice was referred to our hospital. Computed tomography revealed a tumor measuring 9×6 cm in the second portion of the duodenum that had invaded the liver(S6)and head of the pancreas. After percutaneous transhepatic biliary drainage for obstructive jaundice, the patient underwent subtotal stomach-preserving pancreaticoduodenectomy, partial resection of the liver(S6), and partial resection of the colon. Histologic examination showed the primary tumor to be moderately and poorly differentiated adenocarcinoma with hepatic and pancreatic invasion; lymph node metastasis was not found...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133195/-a-case-of-borderline-resectable-pancreatic-cancer-responding-to-preoperative-gem-plus-nab-ptx-combination-chemotherapy
#20
Takuya Fujimoto, Tomio Ueno, Kazuhiko Sakamoto, Satoshi Matsukuma, Hiroto Matsui, Yoshitaro Shindo, Yukio Tokumitsu, Shinsuke Kanekiyo, Michihisa Iida, Yoshihiro Tokuhisa, Nobuaki Suzuki, Shigeru Takeda, Shigefumi Yoshino, Shoichi Hazama, Hiroaki Nagano
We report a case of borderline resectable(BR)pancreatic cancer, which was eligible for R0 resection following preoperative chemotherapy with GEM plus nab-PTX. A 77-year-old woman presented with brown urine and clay-colored stool. After further examination, she was diagnosed with obstructive jaundice due to pancreatic head cancer. Because the tumor was in contact with the region attached to the SMA nerve plexus, she was also diagnosed with BR-A pancreatic cancer. After 6 courses of preoperative GEM plus nab-PTX combination chemotherapy, she underwent subtotal stomach-preservingpancreaticoduodenectomy with SMV resection and right semicircular SMA nerve plexus dissection...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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