1/4. An unusual cause of recurrent biliary colics.Hepato-biliary ascariasis is a rare condition in non-endemic areas; however, it should always be taken into account in patients with recurrent biliary colics and/or cholangitis, since these are among the most frequent modes of clinical presentation. We report a case of a young woman suffering from recurrent biliary colics in whom a diagnosis of biliary ascariasis was made. Endoscopic retrograde cholangiopancreatography with sphincterotomy and endoscopic extraction of the worm, using a Dormia basket, proved to be a safe and effective procedure for removing the living ascaris from the biliary tree and relieving symptoms. In the era of worldwide travels, physicians in Western countries should be more aware of this infection especially in patients with biliary symptoms who have travelled to endemic areas or immigrant from endemic countries.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. Clonorchis-associated cholangiocarcinoma: a report of two cases with unusual manifestations.Two cases of Clonorchis-associated cholangiocarcinoma are described along with their cholangiographic features to illustrate the spectrum of pathology ascribed to the injurious effects of the flukes on the bile duct epithelium. This includes adenomatous hyperplasia, extensive fibrosis, and carcinoma. The first case was also complicated by hepatic abscesses, left hepatic lobar atrophy, gastrobiliary and biliarocutaneous fistulae. The second case features an unusually dilated pancreatic duct containing pancreaticoliths that was found later to consist of hyperplastic bile duct epithelium, presumably carried by worm migration in the biliary tree. liver sections from both patients showed typical features of hepatic clonorchiasis with the cancer. A knowledge of the wide spectrum of clinical presentation of clonorchiasis, particularly cholangiocarcinoma, might aid Western physicians in averting this serious sequela through prompt eradication of the helminthic infection and early recognition and treatment of its complications.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Unilocular hydatid cyst disease: a challenging diagnosis.echinococcosis, a disease uncommon in the united states, is extremely rare in south dakota, although it is endemic in several regions of the united states and prevalent in certain areas of the world. Due to the mobile state of the world's population, recognition of this disease is important. echinococcosis carries the potential for significant morbidity and mortality which can be minimized by appropriate surgical management. awareness of this disease and proper history taking will allow the physician to make the often challenging diagnosis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. cholangiocarcinoma associated with liver fluke infection: a preventable source of morbidity in Asian immigrants.In the far east infection with the liver flukes clonorchis sinensis and opisthorchis viverrini is the most frequently documented cause of cholangiocarcinoma. liver fluke infection in the united states remains a health problem for more than 500,000 Southeast Asian refugees who have immigrated to this country since 1975. Recent surveys have revealed that up to 26% of Asian immigrants have an active liver fluke infection. However, the common clinical manifestations of this condition, as well as the possibility of developing such long-term sequelae as cholangiocarcinoma, remain unknown to many physicians providing care for this population. This report describes a clinically unsuspected C. sinensis infection associated with cholangiocarcinoma in an elderly Chinese immigrant, and emphasizes the importance of early diagnosis and treatment of all liver fluke infections in the prevention of bile duct neoplasms in high risk populations.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |