• Journal of The Korean Radiological Technologist Association
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• v.25 no.1
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• pp.134-135
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• 1999

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.144-147
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• 1998

Isolated injury to the extrahepatic biliary tract following blunt abdominal trauma is rare, and there is little information especially in children regarding the endoscopic diagnosis and management of occult injury to the biliary tract. We experienced a 5-year-old boy who presented with jaundice 16 days after blunt abdominal trauma and was diagnosed as isolated distal common bile duct stricture by ultrasonography of abdomen. We could get more detailed information about the injury by endoscopic retrograde cholangiopancreatography. We could also manage this isolated common bile duct stricture successfully with endoscopic nasobiliary drainage and plastic stent insertion instead of surgical correction. There appeared to be no recurrence of stricture as evidenced by biochemical test and ultrasonography during 2 years of follow up.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.204-209
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• 2010

Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).

• The Korean Journal of Cytopathology
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• v.3 no.1
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• pp.1-11
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• 1992

From the one hundred forty eight patients with evidence of biliary tract obstruction, 275 bile samples were obtained from percutaneously placed biliary drainage catheters. Of the 148 patients, ova of Clonorchis sinensis were demonstrated in 17 patients (11.5%), with the epithelial cells. Among them, one case also demonstrated coexisting adenocarcinoma. In 105 patients, the medical records were available for review and the clinical diagnoses were malignancy in 99 patients and benign lesion in 6 patients. Of the 99 patients in which clinico-radiologic diagnosis were malignant, cytologic results were positive in 23.2%. Dividing the patients Into two groups, the ones with tumor of bile duct origin (group I) and the others with tumors producing extrinsic compression of bile duct, such as periampullary carcinoma, pancreas head carcinoma or metastatic carcinoma in lymph nodes from tumors of adjacent organs (group II), the cytologic results were positive in 37% and 11.6%, respectively. In patients with histologic confirmation, the positive correlation was found in 50% and 20% in group I and group II, respectively, with remarkable difference between two groups. There were no false positives in cytologic diangosis. The overall concordance rate of cytologic diagnosis with diagnosis of clinical investigation in both benign and malignant lesions was 27.6% and the diagnostic specificity was 100%.

• Clinical and Experimental Pediatrics
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• v.46 no.1
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• pp.86-90
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• 2003

Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.

• The Korean Journal of Cytopathology
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• v.11 no.1
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• pp.11-18
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• 2000

Pancreaticobiliary tract strictures are frequent Indications for endoscopic retrograde cholangiopancreatography(ERCP). We have investigated the brushing cytology in order to determine its efficacy for diagnosis of pancreaticobiliary malisnancies. Brushing cytology during ERCP was evaluated in 56 patients with biliary tract stricture presenting to the Catholic Hospital of Taegu-Hyosung from April 1997 to August 1999. A comparison was made between the cytologic and histologic diagnoses on 32 cases from 30 patients. A diagnosis of malignancy was establishied in 78.1%, benign in 15.6%, and inadequate in 6.3% of the cases. Statistical data on cytologic diagnoses in strictures of the bile duct were as follows; specificity and sensitivity of blushing procedure was 100% & 83.3%, respectively: sensitivity of interpretation was 89.3%: with no false positive cases and 3 false negative cases: predictive value for malignancy was 100% & 100%, respectively: predictive value for benign was 28.6% & 40%,, respectively: overall diagnostic efficiency was 84.4%. It is concluded that brush cytology is a diagnostically reliable, highly specific technique for malignant lesions encounted at ERCP, although a negative result does not rule out the diagnosis of malignancy.

• Investigative Magnetic Resonance Imaging
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• v.6 no.2
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• pp.129-136
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• 2002

Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.151-157
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• 2012

General treatment for cholangiocarcinoma is complete surgical resection. However recurrence is common in those patients. In most of cases the purpose of the treatment for patients with recurrent is palliative. Therefore we adopt intraluminal catheter to treat a recurrent patient with high-dose-rate intraluminal brachytherapy. This study aims to evaluate the treatment procedure and set-up reproducibility of intraluminal brachytherapy in the recurrent patient. Study patient was diagnosed at rcT1N0M0 and undergone intraluminal brachytherapy after Arrow Sheath insertion. 3 Gy was delivered in every fraction with a total dose of 30 Gy. We planned dose normalization at distal, proximal and central axis point of narrowed bile duct far from 1 cm. To evaluate set-up reproducibility, we measured distance between distal, proximal treatment target volume point and anterior surface of the thoracic vertebral body respectively for five times before every treatment with dummy seed insertion. Mean distance between distal, proximal treatment target volume point and anterior surface of 10th and 11th thoracic vertebral bodies is 0.5 cm, 6.1 cm and standard deviation is 0.06, 0.08 respectively. In addition, set-up reproducibility was maintained significantly. The patient has been alive with no evidence of disease recurrence for more than a year and has not yet reported severe complications. In conclusion, high-dose-rate intraluminal brachytherapy for unresectable recurrence of cholangiocarcinoma maintains high set-up reproducibility without severe side effects.