• Title/Summary/Keyword: biliary tract

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Helicobacter Species are Possible Risk Factors of Cholangiocarcinoma

  • Kaewpitoon, Soraya J;Loyd, Ryan A;Rujirakul, Ratana;Panpimanmas, Sukij;Matrakool, Likit;Tongtawee, Taweesak;Kootanavanichpong, Nusorn;Pengsaa, Prasit;Kompor, Ponthip;Chavengkun, Wasugree;Kujapun, Jirawoot;Norkaew, Jun;Ponphimai, Sukanya;Padchasuwan, Natnapa;Polsripradist, Poowadol;Eksanti, Thawatchai;Phatisena, Tanida;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.37-44
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    • 2016
  • Several infectious agents are considered to be causes of cancer in human, mainly hepatitis B and C viruses, high-risk human pailloma viruses, Helicobacter pylori, Clonorchis sinensis, and Opisthorchis viverrini. Here we described the evident research and the association between Helicobacter spp. and biliary tract cancer particularly cholangiocarcinoma (CCA). Global epidemiological studies have suggested that Helicobacter spp. are possible risk factors for biliary tract diseases. Molecular studies support a linkage of Helicobacter spp. with CCA development. H. pylori, H. bilis, and H. hepaticus, are found in CCA, but the most common species are H. pylori and H. bilis. The type of CCA are associated with Helicobacter spp. include extrahepatic CCA, and common bile duct cancer. Up to the present, however, the results from different regions, materials and methods, sub-sites of cancer, and controls have not been consistent, thus introducing heterogeneity. Therefore, a comparison between co-Helicobacter spp.-CCA in the countries with low and high incident of CCA is required to settle the question. Furthermore, clarifying variation in the role of Helicobacter species in this CCA, including pathogenesis of CCA through enhanced biliary cell inflammation and proliferation, is necessary.

A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct (낭성 담도 확장을 동반한 담도 유두종증 1예)

  • Park, Yoo Mi;Rhee, Kwangwon;Yoon, Sun Och;Ha, Ji Yoon;Park, So Young;Lee, Jung Ho;Jang, Sung Ill
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.136-140
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    • 2012
  • A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

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Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young;Lee, Jae Sin;Kim, Dong Ryul;Jang, Jae Young;Jung, Hwa Young;Park, Jong Ho;Jin, Sue Sin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.109-113
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    • 2018
  • A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Analytic Study of 362 Bile Cytologic Materials (담즙 세포학 표본 362건의 검색)

  • Koh, Jae-Soo;Ha, Chang-Won;Myong, Na-Hye;Cho, Kyung-Ja;Jang, Ja-June
    • The Korean Journal of Cytopathology
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    • v.2 no.2
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    • pp.73-78
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    • 1991
  • A total of 362 bile samples from 104 patients with evidence of biliary tract obstruction were submitted for diagnostic cytology from January, 1989 to April, 1991. The patients were classified based on the obstructive cause, and the cytologic results were reviewed. 298 of the specimens were from patients with intrabiliary malignant structure, and 17 were from patients with extrabiliary malignant compression or benign biliary obstruction. Bile cytology was positive for carcinoma in 42 samples from patients with intrabiliary malignant stricture, and the diagnostic sensitivity was 14%. There were no false positive cases. We concluded that the cause of low sensitivity was degenerative change of cell due to prolonged sampling time. What is noteworthy was the high prevalence of Clonorchis sinensis eggs, being detected in 25 patients with intrabiliary malignancy, supporting the association between clonorchiasis and biliary tree malignancy.

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Primary hepatic sarcoidosis presenting with cholestatic liver disease and mimicking primary biliary cholangitis: a case report

  • Park, Young Joo;Woo, Hyun Young;Kim, Moon Bum;Ahn, Jihyun;Heo, Jeong
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.256-261
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    • 2022
  • Sarcoidosis often involves the liver. However, primary hepatic sarcoidosis confined to the liver without evidence of systemic involvement is rare. We report the case of a 37-year-old man with hepatic sarcoidosis who initially presented with elevated liver enzymes and suspicious cirrhotic nodules on computed tomography. The patient had cirrhosis but did not have portal hypertension. Based on the initial histopathologic finding of chronic granulomatous inflammation and the common clinical characteristics of sarcoidosis, he was initially diagnosed with primary biliary cholangitis, and his daily dosage of ursodeoxycholic acid was increased to 900 mg. After 14 months of treatment, his total serum bilirubin concentration was 10.9 mg/dL (upper normal limit, 1.2 mg/dL). Additionally, a transjugular liver biopsy revealed multiple noncaseating granulomas. He was diagnosed with primary hepatic sarcoidosis involving the lungs, heart, spleen, kidneys, and skin. Treatment with methylprednisolone was initiated. Two weeks later, he was started on azathioprine, and the dose of steroid was simultaneously reduced. These findings indicate the importance of including hepatic sarcoidosis as a possible diagnosis in patients with elevated liver enzymes or cryptogenic cirrhosis.

Radiological and Ultrasonographic Examination in Diagnosis of Diseases of Biliary system (담도계질환(膽道系疾患)의 방사선(放射線) 및 초음파검사(超音波檢査)에 대한 고찰)

  • Son, Tae-Hyu;Kang, Shin-Hwa
    • The Journal of the Korean life insurance medical association
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    • v.3 no.1
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    • pp.90-102
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    • 1986
  • The gallbladder is a pear-shaped, thin walled sac located on the inferior surface of the liver between the right and quadrate lobe, in a recess called fossa vesicae felleae. It is 7.5cm-12.5 cm in length, 3.5 cm in the largest width, and has a volume of about 45 ml with a remarkable capacity for expansion. There are many kinds of diagnostic methods to evaluate diseases of biliary tract including gallbladder-Plain abdomen, Oral cholecystography. Intravenous cholangiography, Percutaneous transhepatic cholangiography(PTC), Endoscopic retrograde cholangiography(ERCP), Operative or T-tube cholangiography, Ultrasonography, Radioisotope study, Computed tomography, and Angiography. Especially, ultrasonography is the most effective and noninvasive study in these days. Plain abdomen, oral cholecystography, intravenous cholangiography, and ultrasonography have been performed in our clinic. Methods and findings of above mentioned study are discussed with consideration of references.

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Bile Peritonitis Due to Spontaneous Rupture of Choledochal Cyst Diagnosed by Hepatobiliary Scintigraphy in an Infant (영아에서 간담도 스캔으로 진단된 총 담관낭의 자연 천공에 의한 담즙성 복막염 1례)

  • Kim, Jong-Seok;Lim, Jang-Hun;Bae, Sang-Nam;Lee, Jun-Woo;Kim, In-Ju;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.186-191
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    • 2002
  • Choledochal cyst is a congenital anomaly with classic triad of abdominal pain, jaundice and right upper abdominal mass. Bile peritonitis caused by cyst rupture is relatively not rare in infancy. The mechanism of rupture must be epithelial irritation of the biliary tract by refluxed pancreatic juice caused by pancreatico-biliary malunion associated with mural immaturity in infancy, rather than an abnormal rise in ductal pressure or congenital mural weakness at a certain point. We experienced a case of bile peritonitis caused by spontanenous rupture of choledochal cyst in a 10-month-old girl presented with abdominal distension, persistent fever, diarrhea, irritability and intractable ascites. She was presumed as having bile peritonitis by bile colored ascitic fluid with elevated bilirubin level and diagnosis was made by $^{99m}Tc$ DISIDA hepatobiliary scan showing extrahepatic biliary leak. The perforated cyst was surgically removed and the biliary tree was reconstructed with a Roux-en-Y hepaticojejunostomy.

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Calcium-Dependent Cell Damage Induced by Bile Acid

  • Kim, Joo-Young;Kim, Kyung-Hwan;Lee, Min-Goo
    • Proceedings of the Korean Biophysical Society Conference
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    • 2002.06b
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    • pp.24-24
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    • 2002
  • The mechanism of how cholelithiasis increases the risk of acute pancreatitis remains obscure. When gallstones obstruct the lower biliary tract, bile acids can enter the pancreas either by luminal diffusion or by interstitial leakage. Here we provide the first evidence that bile acids can be transported into pancreatic acinar cells through the membrane transporters and induce cell death by impairing intracellular Ca$\^$2+/ signals.(omitted)

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