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tomography in obstructive jaundice

Hendra Koncoro, I Komang W D Putra, I Dewa N Wibawa
Macrocystic serous cystadenoma is an unusual and essentially benign pancreatic tumor. Herein, we report on a 40-year-old woman diagnosed with macrocystic serous cystadenoma who presented with obstructive jaundice. A cystic lesion in the head and body of the pancreas was revealed by abdominal computed tomography. Intraoperative pancreatic cyst aspiration ruled out mucinous cystic neoplasm which has a malignant potential. The pancreatic cyst fluid cytology was basophilic amorph materials concluded as benign cystic lesion...
April 2016: Acta Medica Indonesiana
Jane Lim, Nicholas N Nissen, Christopher McPhaul, Alagappan Annamalai, Andrew S Klein, Vinay Sundaram
Peribiliary cysts are cystic dilatations of peribiliary glands in the liver. They are present in ~50% of cirrhotic patients, but are underrecognized because they are usually asymptomatic and rarely present as obstructive jaundice. A 63-year-old male with hepatitis C cirrhosis, awaiting liver transplantation, had a new finding of intrahepatic dilatation on magnetic resonance imaging. This was initially concerning for cholangiocarcinoma, but was ultimately diagnosed as peribiliary cysts. Peribiliary cysts can imitate cholangiocarcinoma on imaging...
2016: Journal of Surgical Case Reports
Nobuhito Ikeuchi, Takao Itoi, Ryosuke Tonozuka, Shuntaro Mukai, Yohei Koyama, Takayoshi Tsuchiya, Tetsuya Matsumoto, Yasutaka Mizuno, Itaru Nakamura, Akina Hino, Fuminori Moriyasu
A 58-year-old Japanese woman came to our institution because of leg edema and abdominal distention. She had developed acute pancreatitis 5 times in the past 3 years. Dilation of the bile duct and main pancreatic duct without obstruction was observed on computed tomography and magnetic resonance cholangiopancreatography. The presence of Strongyloides stercoralis was highly suspected from the biopsy sample from the duodenal papilla. Polymerase chain reaction amplification and sequencing of small subunit rDNA from paraffin-embedded specimens identified the worm as S...
2016: Internal Medicine
Akane Yamabe, Atsushi Irisawa, Kenji Notohara, Goro Shibukawa, Mariko Fujisawa, Ai Sato, Yoshitsugu Yoshida, Noriyuki Arakawa, Tsunehiko Ikeda, Ryo Igarashi, Takumi Maki, Shogo Yamamoto
The patient was a 42-year-old man who presented at our hospital with obstructive jaundice. Although antinuclear antibody test results were negative, and immunoglobulin G4 (IgG4) was not elevated, endoscopic ultrasound revealed a mixed internal hyperechoic and diffuse hypoechoic pattern, a finding consistent with autoimmune pancreatitis. Endoscopic retrograde cholangiopancreatography further revealed irregular narrowing of the main pancreatic duct and sclerosing cholangitis with distal biliary stricture. In addition, endoscopic ultrasound with fine needle aspiration cytology resulted in a diagnosis of type 1 autoimmune pancreatitis...
October 2016: Clinical Journal of Gastroenterology
Rishi Philip Mathew, Abdunnisar Moorkath, Ram Shenoy Basti, Hadihally B Suresh
BACKGROUND: Objective; To find out the role of MDCT in the evaluation of obstructive jaundice with respect to the cause and level of the obstruction, and its accuracy. To identify the advantages of MDCT with respect to other imaging modalities. To correlate MDCT findings with histopathology/surgical findings/Endoscopic Retrograde CholangioPancreatography (ERCP) findings as applicable. MATERIAL/METHODS: This was a prospective study conducted over a period of one year from August 2014 to August 2015...
2016: Polish Journal of Radiology
Fabrice Vultaggio, Pierre-Henri Morère, Christophe Constantin, Michel Christodoulou, Didier Roulin
Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else...
June 27, 2016: World Journal of Gastrointestinal Surgery
Atsushi Nanashima, Naoya Imamura, Yuki Tsuchimochi, Masahide Hiyoshi, Yoshiro Fujii
INTRODUCTION: This case report is intended to inform pancreas surgeons of our experience in operative management of aberrant pancreatic artery. PRESENTATION OF CASE: A 63-year-old woman was admitted to our institute's Department of Surgery with obstructive jaundice, and the pancreas head tumor was found. To improve liver dysfunction, an endoscopic retrograde nasogastric biliary drainage tube was placed in the bile duct. Endoscopic fine-needle aspiration showed a pancreas head carcinoma invading the common bile duct, the aberrant right hepatic artery arising from the superior mesenteric artery, and the portal vein...
2016: International Journal of Surgery Case Reports
Teng Yu, Genbo Xu, Xiaohua Xu, Jing Yang, Luyin Ding
Myeloid sarcoma is a type of malignant neoplasm composed of myeloblasts that locates extramedullary. The present study reports the case of a 31-year-old female who presented with upper abdominal pain, melena, vomiting and jaundice. The abdominal computed tomography revealed a mass in gastric antrum area and possible infiltration of the duodenum, gallbladder and head of the pancreas, with possible retroperitoneal lymph node metastasis. The tumor grew quickly and led to serious obstructive jaundice. New masses developed in the bilateral orbits and left breast within 2 months of admission...
June 2016: Oncology Letters
Tetsuya Urasaki, Makoto Kodaira, Masaki Hibino, Shingo Yamagata, Yukihiro Watanabe, Yasuyuki Terazawa, Munetaka Sano, Ken Kuriki
This report describes two cases with obstructive jaundice caused by poorly differentiated gastric adenocarcinoma. Computed tomography scans showed circumferential stenosis in the hilar bile ducts. Endoscopic retrograde cholangiopancreatography showed dilatation of the bilateral hepatic ducts and stenosis of the common hepatic ducts from the bifurcation of the bilateral hepatic ducts. The first diagnoses were hilar cholangiocarcinoma and biliary drainage decreased serum bilirubin; however, both patients died of cancer within a short period of time...
2016: Internal Medicine
Tetsuo Kimura, Hiroshi Miyamoto, Akira Fukuya, Shinji Kitamura, Koichi Okamoto, Masako Kimura, Naoki Muguruma, Tetsuya Ikemoto, Mitsuo Shimada, Akiko Yoneda, Yoshimi Bando, Makoto Takishita, Tetsuji Takayama
Neuroendocrine carcinoma (NEC) of the pancreas is very rare, and its origin is not fully elucidated. Here, we present a case of a small-size NEC of the pancreas that is genetically similar to invasive ductal adenocarcinoma (IDA). A 65-year-old man was referred to our hospital due to obstructive jaundice and found to have a 12-mm solid tumor in the pancreas head. The tumor exhibited low vascularity on enhanced computed tomography, and endoscopic retrograde pancreatographic imaging revealed an irregular obstruction in a branch duct of the pancreas...
August 2016: Clinical Journal of Gastroenterology
Sheshang U Kamath, Satish B Dharap, Vineet Kumar
BACKGROUND: The incidence of common bile duct (CBD) calculi has been reported to be 8 % to 20 % among the patients with cholelithiasis. Failure to detect CBD stones on the part of the surgeon not only fails to relieve symptoms but also subjects them to potentially life-threatening complications such as cholangitis, pancreatitis or obstructive jaundice. Modalities for detection of CBD stones have evolved over time from CBD exploration based on clinical and operative findings to intraoperative cholangiography (IOC), to endoscopic retrograde cholangiopancreaticography (ERCP) and, recently, to magnetic resonance cholangiopancreaticography (MRCP) and endoscopic ultrasonography (EUS)...
May 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Mitsuhito Koizumi, Teru Kumagi, Taira Kuroda, Nobuaki Azemoto, Hirofumi Yamanishi, Yoshinori Ohno, Tomoyuki Yokota, Hironori Ochi, Kazuhiro Tange, Yoshiou Ikeda, Yoichi Hiasa
Pancreatobiliary fistulas associated with intraductal papillary mucinous neoplasms (IPMN) often develop obstructive jaundice and cholangitis; thus, early diagnosis is important. However, computed tomography and cholangiography, the current methods for detecting pancreatobiliary fistulas, are not always effective. We previously reported a case of IPMN-associated pancreatobiliary fistula and proposed a potential new diagnostic marker: the "pig-nose" appearance of the duodenal papilla, which results from dilated pancreatic and bile ducts and can be visualized via endoscopy...
April 2016: Endoscopy International Open
Jack Husney, Steven Guttmann, Nnaemeka Anyadike, Ira Mayer, Rabin Rahmani
Plasmacytoma is a neoplastic production of a single line of plasma cells, usually forming monoclonal immunoglobulin. It most often occurs in the bone marrow; however, in 3% of the cases, solitary extramedullary plasmacytoma arises, which is a proliferation in the soft tissue, outside the bone marrow. In only 10% of the cases is the gastrointestinal tract involved. A 77-year-old female presented with lethargy, abdominal fullness, bilious vomiting, and clay-colored stools. The patient was anemic with initial laboratory results showing increased total and direct bilirubin with elevated transaminases...
March 2016: Endoscopic Ultrasound
Esther Tahover, Rachel Bar Shalom, Naama Bogot, David Kelsen, Alberto Gabizon
Here, we present a case of an 84-year-old woman who developed obstructive jaundice and was diagnosed with nonoperable adenocarcinoma originating from the ampulla of Vater, a lethal disease with a median overall survival of less than a year. Her tumor was examined by next-generation sequencing, which showed BRAF and NRAS mutations. To target these mutations, a MEK inhibitor was chosen for treatment. The patient has been treated with a MEK inhibitor for the last 12 months since diagnosis, with clinical and laboratory improvement and manageable side effects...
July 2016: Anti-cancer Drugs
Takuya Yano, Tsuyoshi Kobayashi, Shintaro Kuroda, Hironobu Amano, Hirotaka Tashiro, Hideki Ohdan
Hemangioma is the most common benign tumor of the liver. Liver hemangioma (LH) usually remains asymptomatic, but the most common symptoms associated with LH are abdominal pain and discomfort. LH is an uncommon cause of bile duct dilatation and obstructive jaundice. An 83-year-old Japanese woman who received hemodialysis at another hospital was referred to our hospital because of abnormal liver function and obstructive jaundice. Abdominal computed tomography and magnetic resonance imaging revealed a 13-cm tumor in liver segments IV-V and intrahepatic bile duct dilatation...
December 2015: Surgical Case Reports
Yoshiaki Isono, Shimpei Matsusaki, Hiroki Tanaka, Tomomasa Tochio, Hiroaki Kumazawa, Tomohiro Sase, Tomonori Saito, Hiroshi Okano, Youichirou Baba, Katsumi Mukai
An 85-year-old woman with jaundice was referred to our hospital where she was diagnosed with obstructive jaundice due to carcinoma of the pancreatic head based on blood tests and abdominal computed tomography (CT). We performed endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage, but 5 days after the procedure, she complained of epigastric pain. Laboratory data revealed an elevated white blood cell count and a high serum amylase concentration. Follow-up CT 6 days after the ERCP revealed that the main pancreatic duct diameter had increased since the time of admission...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Nobuhiko Fukuba, Ichiro Moriyama, Shunji Ishihara, Hiroki Sonoyama, Noritsugu Yamashita, Yasumasa Tada, Akihiko Oka, Naoki Oshima, Takafumi Yuki, Kousaku Kawashima, Yoshikazu Kinoshita
A 60-year-old woman was admitted to our hospital with upper abdominal pain and jaundice. Computed tomography showed a 9-cm mass that was penetrated by the common hepatic artery in the pancreatic head area. Endoscopic retrograde pancreatography revealed no stenosis or obstruction of the main pancreatic duct, and a cytologic examination of the patient's pancreatic juice was negative. Next, endoscopic ultrasound-guided fine needle aspiration was performed. The immunohistological findings of the specimen revealed a diffuse large B-cell lymphoma...
2016: Internal Medicine
Bharivi Jani, Fadi Rzouq, Shreyas Saligram, Atta Nawabi, Marian Nicola, Katie Dennis, Carly Ernst, Ali Abbaszadeh, John Bonino, Mojtaba Olyaee
CONTEXT: Groove pancreatitis is a rare form of chronic pancreatitis affecting the "groove" of the pancreas among the pancreatic head, duodenum, and common bile duct. The exact cause is unknown, although there are associations with long-term alcohol abuse, smoking, peptic ulcer disease, heterotopic pancreas, gastric resection, biliary disease, and anatomical or functional obstruction of the minor papilla. The diagnosis can be challenging. Endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography are the preferred imaging modalities...
November 2015: North American Journal of Medical Sciences
Keiichi Fujiya, Hideaki Ganno, Masayuki Ando, Ja-Mun Chong
Infection with the trematode Clonorchis sinensis is the most common human fluke infection in East Asian populations. Although this infection is associated with obstructive jaundice or choledocholithiasis, portal vein thrombosis has not been reported. Here, we report the first case of a 60-year-old man who had both C. sinensis infection and portal vein thrombosis with severe hyperbilirubinemia (75.4 mg/dl). He initially presented with abdominal pain and jaundice. Computed tomography revealed gallstones, common bile duct calculus, and thrombus in the left main branch of the portal vein...
March 2016: Diagnostic Cytopathology
Chang-Zhong Yu, Cong-Hui Yu, Chao Nai, Ju Tian
INTRODUCTION: Obstructive jaundice caused by metastases to the distal common bile duct or the ampulla of Vater is often observed in patients with various advanced cancers; however, metastasis of lung cancer to the ampulla of Vater with subsequent development of jaundice is rare. CASE PRESENTATION: The patient was a 41-year-old Chinese female who presented with apparent jaundice and itching. An enlarged right supraclavicular lymph node was found during physical examination...
2015: International Journal of Clinical and Experimental Medicine
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