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tomography in obstructive jaundice

Tomasy Sarosiek, Małgorzata Stelmaszuk
Small intestine tumors are rarely diagnosed as they constitute only 0.6% of all malignant tumors, including about 1-3% of malignant neoplasms of the gastrointestinal tract. They also advocate for 0.2% of deaths caused by malignant tumors. Factors that increase the risk of disease include Crohn's disease, familial adenomatous polyposis (FAP), Lynch syndrome (HNPCC - hereditary non-polyposis colorectal cancer), Peuz-Jeghers syndrome, celiac disease and acquired immunodeficiency syndrome (AIDS). Diagnosis of small intestinal tumors is difficult because the symptoms reported by patients are not characteristic...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Dongbing Ding, Yao Yao, Songbai Zhang
Duodenal mucinous adenocarcinoma (DMA) is a malignancy with a rather low morbidity. However, its incidence in China has not been clearly determined. We herein report a case of a 70-year-old female patient who presented with ileus, obstructive jaundice and massive ascites simultaneously. Gastroendoscopy revealed copious amounts of colloidal mucin in the gastric cavity. The neoplasm was not visualized on computed tomography or magnetic resonance imaging, and an exploratory laparotomy was performed to investigate the abdomen...
March 2018: Molecular and Clinical Oncology
Hitomi Hamamoto, Shinichi Hashimoto, Hiroki Taguchi, Issei Kojima, Ai Kasai, Kengo Tsuneyoshi, Kosuke Kuwazuru, Shiho Arima, Shuji Kanmura, Akio Ido
A 63-year-old woman was admitted with epigastric pain, eosinophilia, and elevated hepatobiliary enzyme levels. An upper gastrointestinal endoscopic examination showed that the mucosa of the gastroduodenal wall was edematous. Eosinophilic gastroenteritis (EGE) was diagnosed based on eosinophilic infiltration of the gastroduodenal mucosa. Computed tomography showed invagination of the duodenal wall into the common bile duct. The invagination of the duodenal wall improved after conservative therapy, while bile duct drainage was impossible due to the narrowing of the duodenal lumen...
February 9, 2018: Internal Medicine
Koji Takada, Shinichiro Kashiwagi, Ryosuke Amano, Wataru Goto, Yuka Asano, Go Ohira, Kenjiro Kimura, Masahiko Ohsawa, Kosei Hirakawa, Masaichi Ohira
A 71-year-old woman visited her nearby hospital because jaundice and right hypochondralgia. She was diagnosed as obstructive jaundice due to duodenal papillary carcinoma and was introduced to our hospital. Chest computed tomography showed some tumors in both lung and left breast, then the breast tumor was diagnosed as primary breast cancer by needle biopsy. Since it was difficult to distinguish whether multiple tumor of lung was primary lung cancer or metastasis, right pulmonary partial resection using a thoracoscope was performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kazuhiro Suzumura, Etsuro Hatano, Naoki Uyama, Toshihiro Okada, Yasukane Asano, Seikan Hai, Keiji Nakasho, Jiro Fujimoto
A 59-year-old male patient with jaundice was referred to our hospital because of mass lesions in the pancreatic head and tail. An immunological examination revealed an elevated serum IgG4 level. Computed tomography showed two clear boundary mass lesions in the pancreatic head and tail. Magnetic resonance imaging showed that the mass lesions exhibited low intensity on T1-weighted images and iso-intensity on T2-weighted images. Magnetic resonance cholangiopancreatography showed an obstruction of the main pancreatic duct in the pancreatic head and tail...
September 2017: Case Reports in Gastroenterology
Bharadhwaj Ravindhran, Clement Prakash, Sridar Govindharaj, Noor Mohammed Shawnaz Bahnou, B Pavithra
Diffuse Large B-Cell Lymphoma (DLBCL) is the most common histological subtype of Non-Hodgkin's Lymphoma (NHL). Primary retroperitoneal DLBCL is uncommon and has seldom been reported. Extrinsic compression of the duodenum due to lesions originating from the retroperitoneum is also rare. We present a case of a 39-year-old man who presented with inability to tolerate oral intake, abdominal pain, an upper abdominal mass and postprandial bilious vomiting caused by a large DLBCL arising from the retroperitoneum causing extrinsic compression of the duodenum...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Pramod Nepal, Kosei Maemura, Yuko Mataki, Hiroshi Kurahara, Yota Kawasaki, Kiyokazu Hiwatashi, Satoshi Iino, Masahiko Sakoda, Takaaki Arigami, Sumiya Ishigami, Hiroyuki Shinchi, Shoji Natsugoe
BACKGROUND: Perforation of the horizontal duodenum is very rare due to the presence in retroperitoneal space. It depicts an unusual clinical picture and is difficult to diagnose, leading to increased morbidity and mortality. The treatment strategies are usually varied and based on small series of cases, literature reviews, and expert opinions. CASE PRESENTATION: Here, we presented three cases of horizontal duodenal perforation in three different clinical processes...
December 1, 2017: Surgical Case Reports
Seikan Hai, Etsuro Hatano, Tadamichi Hirano, Yasukane Asano, Kazuhiro Suzumura, Hideaki Sueoka, Jiro Fujimoto
Right-sided ligamentum teres (RSLT) is a rare congenital anomaly often accompanied by variation of the hepatic vasculature. We herein report a surgical case of a hilar cholangiocarcinoma with RSLT in whom preoperative hepatectomy simulation proved useful for understanding the anatomical structure of the liver. A 78-year-old male with obstructive jaundice was referred to our department for further examination. The patient was suspected of having a hilar cholangiocarcinoma originating from the left hepatic bile duct by contrast-enhanced computed tomography (CT), and CT also showed right umbilical portion (RUP)...
September 2017: Case Reports in Gastroenterology
Masatake Nishiwaki, Chiemi Mizuno, Kota Yano, Hirohisa Oya, Ichiro Amano, Junko Matsumoto, Izumi Tanaka, Naoki Sawai, Masayuki Mizuno, Toshihide Shima, Yoshiharu Miyamoto, Takeshi Okanoue
An 85-year-old woman underwent endoscopic retrograde cholangiopancreatography (ERCP) for obstructive jaundice. Selective bile duct cannulation was unsuccessful because of periampullary diverticula (PAD). A pancreatic spontaneous dislodgement stent (PSDS) (5F diameter, 3 cm, straight type) was inserted to prevent post-ERCP pancreatitis. Three days after ERCP, she complained of abdominal pain, and computed tomography revealed retroperitoneal perforation because of PSDS migration to the PAD. If the papillary orifice is observed at the diverticular rim or in the diverticula, a pigtailed PSDS on the duodenal side or flanged stent on the pancreatic ductal side should be inserted in order to prevent this rare adverse event...
November 1, 2017: Internal Medicine
Syed Faisal Jafri, Obada Obaisi, Gerardo G Vergara, Joe Cates, Jaswinder Singh, Jennifer Feeback, Harathi Yandrapu
Desmoid type fibromatosis (DTF) is a rare, locally invasive, non-metastasizing soft tissue tumor. We report an interesting case of DTF involving the pancreatic head of a 54-year-old woman. She presented with intermittent dysphagia and significant weight loss within a 3-mo period. Laboratory findings showed mild elevation of transaminases, significant elevation of alkaline phosphatase and direct hyperbilirubinemia, indicating obstructive jaundice. Computerized tomography of the abdomen revealed a mass in the head of the pancreas, dilated common bile duct, and dilated pancreatic duct...
September 15, 2017: World Journal of Gastrointestinal Oncology
P A Heedman, E Åstradsson, K Blomquist, R Sjödahl
BACKGROUND AND AIM: Endoscopic stents in the common bile duct is the first treatment choice to alleviate symptoms of biliary obstruction due to malignant disease. When endoscopic stenting fails in palliative patients, one option is to use a percutaneous transhepatic biliary drainage, but it is not clear whether and how it can reduce the symptom load. The aim of this study was to evaluate benefits and disadvantages of percutaneous transhepatic biliary drainage in palliative care. MATERIAL AND METHODS: Inclusion criteria were malignant disease and bilirubin ≥26 µmol/L in plasma...
September 1, 2017: Scandinavian Journal of Surgery: SJS
Xiao-Yu Yang, Hai-Bo Zhang, Bin Wu, Ai-Jun Li, Xiao-Hui Fu
Bile duct hamartoma (BDH) is a rare liver disease with a rising incidence in recent years. A retrospective study on BDH patients between June 2007 and December 2015 was conducted. All the medical records, including clinical, imaging and pathological characteristics, were retrieved. Follow-up data were obtained by telephone communication. The majority of the patients had no symptoms and the laboratory tests were normal. The appearance on ultrasound examination was variable. The lesion exhibited low density on plain computed tomography and no enhancement in 4 cases, and inhomogeneous enhancement in 1 case...
October 2017: Molecular and Clinical Oncology
Foroogh Forghani, Mohsen Masoodi, Maryam Kadivar
Primary hepatic lymphoma (PHL) presenting with obstructive jaundice is rare and can mimic a preoperative diagnosis of cholangiocarcinoma. We should consider PHL in patients with radiological hepatic disease with normal serum alpha-fetoprotein and carcinoembryonic antigen levels, and elevated lactate dehydrogenase. We present the case of a 67-year-old male with no significant medical history presented with abdominal pain, jaundice, fever, and abnormal liver function tests. Abdominal sonography and computed tomography scan suggested a diagnosis of obstructive jaundice and cholangitis due to cholangiocarcinoma (Klatskin tumor)...
July 2017: Oman Medical Journal
Yu-Ki Takemoto, Tomoyuki Abe, Hironobu Amano, Keiji Hanada, Akihito Okazaki, Tomoyuki Minami, Tsuyoshi Kobayashi, Masahiro Nakahara, Shuji Yonehara, Hideki Ohdan, Toshio Noriyuki
INTRODUCTION: Mixed adenoneuroendocrine carcinomas (MANECs) derived from cystic duct are extremely rare. PRESENTATION OF CASE: An 80-year-old woman was admitted to the department of surgery, Onomichi general hospital with abnormal liver function and jaundice. Enhanced abdominal computed tomography (CT) detected a well-enhanced papillary tumor in the cystic duct, which protruded into the common bile duct. The intrahepatic bile duct was dilated due to tumor obstruction...
2017: International Journal of Surgery Case Reports
Mounira El Euch, Souha Hddad, Madiha Mahfoudhi, Hela Maktouf, Fethi Ben Hamida, Fatima Jaziri, Khaoula Ben Abdelghani, Sami Turki, Taïeb Ben Abdallah
BACKGROUND Type 1 autoimmune pancreatitis (AIP), also known as lymphoplasmacytic sclerosing pancreatitis (LPSP), is a rare cause of chronic pancreatitis, characterized by a fibro-inflammatory process. However, patients with AIP may have a good response to corticosteroid therapy. We describe a Tunisian patient with AIP that was confirmed to be an IgG4-related disease (IgG4-RD). CASE REPORT We describe a case of a 70-year-old man who was admitted to hospital for obstructive jaundice and abdominal pain. Serum liver function tests were abnormal and upper abdominal computed tomography (CT) imaging showed diffuse pancreatic swelling and strictures of the main pancreatic duct without any focal lesion...
July 24, 2017: American Journal of Case Reports
Anneleen De Both, Marc De Man, Roberto Troisi, Hans Van Vlierberghe, Anne Hoorens, Karen Geboes
The case of a 35-year old female patient with a diagnosis of metastatic mixed acinar-endocrine carcinoma (MAEC) is investigated in the present study. The patient was believed to have a well-differentiated neuroendocrine tumor (NET) with a high Ki-67 index and uptake on (68)Gallium-DOTATOC positron emission tomography-computed tomography for 9 years, and was treated accordingly. The patient had long lasting disease control by treatment with sunitinib, and a response was observed in numerous lesions with peptide receptor radionuclide therapy (PRRT)...
July 2017: Oncology Letters
Alena Ondrejková, Bohuslav Kianička, Hana Nechutová, Lukáš Hruška, Ivo Novotný, Miroslav Souček
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis, classified into 2 subtypes - AIP type 1 and AIP type 2. We present a case of a 31-years-old female admitted to our institution with upper abdominal pain and obstructive jaundice. Endoscopic retrograde cholangiopancreatoscopy (ERCP) revealed stenosis of intrapancreatic distal bile duct. Diffuse parenchymal enlargement and typical features of AIP were shown by computed tomography (CT) and endoscopic ultrasonography (EUS). The patient´s serum IgG4 was elevated at 3...
December 0: Vnitr̆ní Lékar̆ství
Lili Yu, Yajun Chen, Ligang Xing
Primary pancreatic lymphoma (PPL) is an extremely rare disease, with only a few cases reported in the literature. Clinical manifestations of PPL are often nonspecific and may mimic other pancreatic diseases. Because of the limited experience of PPL, clinicopathological features, differential diagnosis, optimal therapy, and outcomes are not well defined. We described two cases diagnosed as PPL and confirmed by histological examination and immunohistochemical analysis. Case 1 was a young man with obstructive jaundice and upper abdominal malaise mimicking a pancreatic adenocarcinoma...
2017: OncoTargets and Therapy
W S L De Silva, A A Pathirana, I Prematilleke, S A P D Rajapakse, P S H Hettiarachchi, D S Manawasinghe, B K Dassanayake
BACKGROUND: Only a limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature. We report a case of two solid malignant tumors of the pancreas diagnosed preoperatively. CASE PRESENTATION: We describe a 65-year-old Sri Lankan woman who presented with progressive obstructive jaundice. Initial contrast-enhanced computed tomography imaging detected a malignant tumor at the tail of her pancreas. A second tumor of the pancreatic head was detected with integrated imaging using multidetector computed tomography and multimodal magnetic resonance imaging...
March 28, 2017: Journal of Medical Case Reports
A A Ullah, A Rahman, L H Chowdhury, A H Bhuiya
Obstructive jaundice due to advance malignancy is a fatal problem. It most commonly occurs at the distal common bile duct or at the hilum of liver. Magnetic Resonance Cholangio Pancreatography (MRCP) and Computed Tomography (CT) are most useful in identifying the underlying cause as well as localize the position of the stricture. For those patients with unresectable disease, progressive jaundice constitutes an immediate threat to their survival, in addition to significant loss to their quality of life secondary to pruritus, malaise and cholangitis...
January 2017: Mymensingh Medical Journal: MMJ
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