11/285. Biliary sepsis as a cause of appearance of endoluminal Tc-99m HMPAO-labeled leukocytes: a case report.A case is presented that shows the abnormal early appearance of Tc-99m HMPAO-labeled leukocytes within the small bowel lumen as a result of septic cholangitis. It is essential to perform early images with Tc-99m HMPAO-labeled leukocytes to differentiate between the appearance of abnormal uptake in the bowel and normal physiologic excretion, which occurs later in the renal and biliary tracts. Endoluminal radiolabeled leukocytes have been described in several clinical settings unrelated to bowel disease, such as swallowed activity from sinus or pulmonary infection, and it is important to differentiate this from primary gastrointestinal disease. To our knowledge, acute pyogenic cholangitis has not been shown previously as a cause of these appearances and should be included in the differential diagnosis for the early appearance of mobile radiolabeled leukocytes in the lumen of the gastrointestinal tract.- - - - - - - - - - ranking = 1keywords = bile (Clic here for more details about this article) |
12/285. Polymicrobial cholangitis and liver abscess in a patient with the acquired immunodeficiency syndrome.cholangitis/cholangiopathy associated with the human immunodeficiency virus (hiv) infection is characterized by chronic abdominal pain, low-grade fever, cholestasis, and sometimes areas of focal or diffuse dilatation of the bile ducts that may be apparent on noninvasive imaging studies. Although the etiology of this biliary disease may be multifactorial, it appears to be the result of immunosuppression and/or secondary opportunistic infections rather than a direct cytopathic effect of hiv itself. Various opportunistic pathogens, including cytomegalovirus, cryptosporidium, campylobacter fetus, and candida albicans, have been implicated as causes of hiv-associated cholangitis. We report an unusual case of polymicrobial cholangitis and liver abscess in a patient with hiv infection.- - - - - - - - - - ranking = 13.638180749453keywords = bile duct, cholestasis, bile, duct, stasis (Clic here for more details about this article) |
13/285. Autoimmune cholangitis with features of autoimmune hepatitis: successful treatment with immunosuppressive agents and ursodeoxycholic acid.We report a 42-year-old Chinese female with elevated serum levels of liver aminotransferases, alkaline phosphatase, gamma-glutamyl transpeptidase, cholesterol and immunoglobulin m. Serum antimitochondrial antibody was negative, but antinuclear antibody was strongly positive. Liver histology showed features of both autoimmune cholangitis and autoimmune hepatitis. Combination therapy with immunosuppressive (prednisone and azathioprine) and choleuretic agents (ursodeoxycholic acid) was given. Serum aminotransferases and biliary enzymes showed much improvement after treatment. A follow-up liver biopsy showed improvement of both hepatic necroinflammation and bile duct damage. Biliary enzymes rose after withdrawal of the immunosuppressive agents and declined again with reinstitution of prednisone. This case demonstrates that a combination of immunosuppressive agents and ursodeoxycholic acid may effectively treat patients with features of both autoimmune cholangitis and autoimmune hepatitis.- - - - - - - - - - ranking = 8.1574730758301keywords = bile duct, bile, duct (Clic here for more details about this article) |
14/285. Radionuclide scintigraphy in Caroli's disease.Congenital cystic dilatation of the intrahepatic bile ducts involving the major intrahepatic radicles was first described by Caroli and hence named as Caroli's disease. We present here a case in which the only symptom was intermittent pain in the abdomen for last one-and-a-half-year and a radionuclide scan done effectively, not only diagnosed the disease but also the associated cholangitis.- - - - - - - - - - ranking = 8.1574730758301keywords = bile duct, bile, duct (Clic here for more details about this article) |
15/285. Recurrent cholestatic jaundice associated with generalized pustular psoriasis: evidence for a neutrophilic cholangitis.Generalized pustular psoriasis can result in systemic complications. We report the case of a woman with relapsing generalized pustular psoriasis and recurring episodes of cholestatic jaundice. Liver biopsy performed during an attack showed a neutrophilic infiltrate surrounding and invading portal triad bile ducts. Ultrasonographic exams and retrograde cholangiography ruled out biliary tract disease. This observation suggests that recurring cholestatic jaundice in pustular psoriasis is related to a neutrophilic cholangitis.- - - - - - - - - - ranking = 8.1574730758301keywords = bile duct, bile, duct (Clic here for more details about this article) |
16/285. Ischemic cholangitis caused by transcatheter hepatic arterial chemoembolization 10 months after resection of the extrahepatic bile duct.We report a case of ischemic cholangitis that occurred after transcatheter hepatic arterial chemoembolization (TAE). Ten months prior to TAE the patient had undergone central bisegmentectomy for hepatocellular carcinoma with resection of the extrahepatic bile duct. Eleven days after TAE, he developed suppurative cholangitis and multiple organ failure. Prior surgical ligation of the peribiliary arteries around the extrahepatic bile duct followed by TAE was considered to have played a crucial role in the development of ischemic cholangitis. This case demonstrates the importance of blood flow from the peribiliary arteries for the survival of the biliary epithelium.- - - - - - - - - - ranking = 265.66844488469keywords = extrahepatic, bile duct, bile, duct (Clic here for more details about this article) |
17/285. Successful removal of a stone and an expandable metallic stent from the biliary tract of a patient with acute occlusive pyogenic cholangitis.We removed a biliary stone and the metallic stent placed two years previously in a patient with benign biliary strictures. An 80-year-old woman who had been inplanted with an expandable metallic stent (EMS) to prevent obstruction by a large common bile duct stone about two years before as an emergency measure in another hospital, was afficted with acute occlusive pyogenic cholangitis (AOPC) and hospitalized in our hospital. After treating the AOPC, we successfully removed the EMS with a cholangioscope and normal biopsy forceps through the percutaneous transhepatic channel under fluoroscopy. The type of the EMS was Accufulex stent. To remove it was easier than expected. Once it started to unravel, it was removed from the common bile duct within a few minutes.- - - - - - - - - - ranking = 16.380730179717keywords = bile duct, bile, duct, obstruction (Clic here for more details about this article) |
18/285. A case of recurrent cholangitis after bile duct injury during laparoscopic cholecystectomy: value of scintigraphy with Tc-99m GSA and hepatobiliary scintigraphy for indication of lobectomy.A 39-year-old woman with acute cholecystitis and gallstones underwent laparoscopic cholecystectomy. She suffered from recurrent episodes of cholangitis due to injury of the major bile ducts during laparoscopic cholecystectomy. Hepatobiliary scintigraphy with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan was performed. Although normal bile excretion was found from the left hepatic duct to the percutaneous transhepatic biliary drainage (PTBD) tube, excretion from the right hepatic lobe was prolonged. Scintigraphy with Tc-99m diethylenetriaminepentaacetic acid-galactosyl human serum albumin demonstrated atrophy of the right hepatic lobe and enlargement of the left hepatic lobe. cholangiography via the PTBD tube revealed complete obstruction of the left hepatico-jejunal anastomosis and could not enhance the right intrahepatic bile duct. A right hepatic lobectomy was performed because of the atrophy, glissonitis and the absence of an appropriate bile duct for reconstruction. Postoperatively she was active and exhibited no evidence of recurrent cholangitis.- - - - - - - - - - ranking = 58.543254009981keywords = bile duct, bile, duct, obstruction (Clic here for more details about this article) |
19/285. Biliary stricture as a possible late complication of radiation therapy.Eleven years after resection of hilar bile duct cancer with postoperative radiation therapy, we experienced a case in which biliary stricture developed. The segment of stricture was proximal to the anastomosis, the same area where irradiation had been performed. There was no sign of recurrence of the bile duct cancer in ultrasonography, computed tomography, and biopsy of the stenotic region. It was suspected that the stricture was a late complication of the postoperative radiation therapy.- - - - - - - - - - ranking = 16.31494615166keywords = bile duct, bile, duct (Clic here for more details about this article) |
20/285. Intrahepatic cholangitis and arteritis after transcatheter arterial embolization in a patient with tumor-like lesion-associated autoimmune hepatitis.Autoimmune hepatitis is a chronic liver disease characterized by immune-mediated, progressive hepatocellular damage, although the target autoantigen remains speculative. Intrahepatic biliary lesions are not a feature of this disease. We describe herein a female patient, 57 years, with autoimmune hepatitis who developed hepatic regenerative mass after acute exacerbation of hepatitis. This hepatic regenerative mass was clinically diagnosed as hepatocellular carcinoma and was surgically resected after transcatheter arterial embolization therapy. Widespread nonsuppurative destructive granulomatous cholangitis as well as necrotizing, granulomatous arteritis of the intrahepatic small arteries were found in the surgically resected hepatic regenerative mass. The bile duct lesions were histologically and immunohistochemically very similar to the granulomatous cholangitis of primary biliary cirrhosis. We would like to propose that these unusual lesions in the intrahepatic bile ducts and intrahepatic arteries represent a reaction of this patient to an anti-cancer drug included in chemoembolization. No such cases have been reported so far.- - - - - - - - - - ranking = 16.31494615166keywords = bile duct, bile, duct (Clic here for more details about this article) |
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