Cases reported "Jaundice, Obstructive"

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1/67. Obstructive jaundice caused by primary choledochal hydatid cyst mimicking radiologically choledochal cyst.

    A 12-year-old girl with obstructive jaundice that was initially misinterpreted radiologically as having choledochal cyst is presented. A primary hydatid cyst in the wall of the common bile duct causing obstruction was found at operation. The authors emphasize that hydatid cyst should be included in the list of differential diagnoses of obstructive jaundice and cystic lesions located around the biliopancreatic junction in children.
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2/67. Schwannoma of the common bile duct: a rare cause of obstructive jaundice.

    The endoscopic diagnosis of bile duct lesions has improved over recent years through the introduction of cholangioscopy and intraductal ultrasound. Combining this with biopsies examined using routinely administered immunohistochemical markers, the diagnosis of tumors of the extrahepatic bile duct can be improved substantially. We report a rare case of a schwannoma of the bile duct causing obstructive jaundice.
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3/67. Inflammatory pseudotumor of the common bile duct.

    An exceptional cause of obstructive jaundice is reported in the present case. A 51-year-old woman progressively developed jaundice with pruritus, and abdominal ultrasonography revealed dilated intra- and extrahepatic bile ducts. Endoscopic retrograde cholangiography and endoscopic ultrasonography showed a tumor in the distal common bile duct, but failed to determine the nature of the lesion, and the patient underwent a pancreaticoduodenectomy. The final diagnosis was an inflammatory pseudotumor of the common bile duct. Inflammatory pseudotumors are uncommon, without evident pathogenesis, and are described in many organs. The localization in the common bile duct is exceptional. The prognosis is good, and a more conservative approach is possible if the diagnosis is certain before surgery.
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ranking = 8
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4/67. Papillomatosis confined to the distal biliary tract--a rare cause of obstructive jaundice: report of a case.

    Based on the findings of a patient with recurrent obstructive jaundice due to papillomatosis of the distal bile duct, we herein describe the diagnostic difficulties and therapeutic options in this very rare disease. Endoscopic retrograde cholangiopancreatography and, in particular, cholangioscopy are the imaging procedures of choice if biliary papillomatosis is suspected. Due to the tendency of such patients to demonstrate malignant transformation and develop biliary cirrhosis with septic complications, an early and radical surgical resection is recommended in rare cases of localized papillomatosis. This approach may offer the only chance of a cure although the potential risk of multifocal recurrence cannot be ruled out. When considering a radical resection, intraoperative cholangioscopy is strongly recommended to confirm any localized papillomatosis and rule out any diffuse papillomatosis of the entire biliary tract.
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5/67. Mucin-producing carcinoma of the cystic duct that caused obstructive jaundice.

    We report a very rare case of what appeared to be mucin-producing carcinoma of the cystic duct, and this is the forth case recorded in the English-language and Japanese literature. The patient was a 67-year-old man with a chief complaint of dark urine and jaundice. cholangiography via an endoscopic nasobiliary drain showed dilatation of the common hepatic duct to 14 mm, with no visualization of the cystic duct or gallbladder, and an approximately 15-mm filling defect was observed at the junction of the common bile duct and the cystic duct. Based on these findings a diagnosis of cancer of the middle portion of the bile duct was made. cholecystectomy and resection of the bile duct with dissection of regional lymph nodes and choledochoduodenostomy were performed. About a 1-cm mass was palpable in the region of the cystic duct, and the gallbladder contained mucin some of which reached the common bile duct. Histological examination revealed well-differentiated ductal adenocarcinoma infiltrating the serosa, in which mucus production was observed. The patient was discharged on postoperative day 50. At the present time, 38 months postoperatively, there are no signs of recurrence, and he is attending the outpatient clinical in good health.
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ranking = 15
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6/67. Small cell carcinoma of the extrahepatic bile duct: case report and immunohistochemical analysis.

    A small cell carcinoma of the extrahepatic bile duct in a 75-year-old Japanese man is reported. The patient suffered from obstructive jaundice, and percutaneous transhepatic cholangiography-drainage (PTCD) revealed a massive lesion in the lower common bile duct. Because it was diagnosed as a malignant tumor, pancreaticoduodenectomy was performed. A nodular infiltrating tumor measuring 4.5 x 3.0 x 2.0 cm was located in the intrapancreatic portion of the extrahepatic bile duct. Histologically, the tumor was composed of a dense proliferation of small atypical cells with a little region of high-grade dysplasia in the adjacent epithelium of the common bile duct. Tumor cells were immunoreactive to neuroendocrine markers such as chromogranin a, synaptophysin, CD56, and Leu7. Although carcinoma cells invaded into pancreas and duodenum, there were no histological findings that indicated the carcinoma arose from the mucosa of either the pancreatic duct or duodenum. These results indicated that the tumor was a small cell carcinoma derived from the epithelium of the extrahepatic bile duct; a rare neoplasm with only a few cases reported. A few neuroendocrine cells were recognized in the adjacent epithelium of the extrahepatic bile duct, suggesting that the tumor cells might be derived from them. Using immunohistochemical examination, no p53 abnormality was found. Tumor cells showed positive nuclear staining for p16, while negative for cyclin d1, suggesting that functional retinoblastoma protein (pRB) might be lost in the p16/pRB pathway, as in small cell lung cancer.
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ranking = 11
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7/67. Endoscopic treatment in a patient with obstructive jaundice caused by pancreatic pseudocyst.

    We report a case of chronic alcoholic pancreatitis with obstructive jaundice due to compression of the common bile duct by pancreatic pseudocyst. ultrasonography and computed tomographic scan on admission demonstrated an 8 cm cystic lesion located at the head of the pancreas. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a segment of narrowing at the distal common bile duct which was compressed by the pancreatic pseudocyst. communication between the cyst and pancreatic duct was also noted. Bacteriological examination of cystic contents yielded the growth of proteus vulgaris, morganella morganii, stenotrophomonas maltophilia and pseudomonas aeruginosa. The patient was treated with broad-spectrum antibiotic, endoscopic sphincterotomy, endoscopic nasopancreatic duct drainage, and transpapillary pancreatic endoprosthesis. jaundice subsided gradually during admission and a marked reduction of pancreatic pseudocyst was found 18 months after discharge.
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ranking = 5
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8/67. Monolobar Caroli's disease in an adult. Case report.

    Caroli's disease is the dilatation of the segmental intrahepatic bile ducts which generally presents in a diffuse form, but may occasionally involve only a single lobe, commonly the left one. We report the case of a 64-year-old male who presented with a clinical picture of obstructive jaundice, with Caroli's disease in segments II and III of the liver. Preoperative diagnosis was made using abdominal ultrasound and computed tomography scan, confirmed by endoscopic retrograde cholangiopancreatography. The treatment used was segmentectomy II and III (left lobectomy--Couinaud's classification) of the liver. Macroscopic examination of the resected specimen revealed cystic dilatation of the intrahepatic bile ducts and intrahepatic lithiasis. Histologically there was no evidence of malignancy. liver resection is the treatment of choice for Caroli's disease confined to a single lobe or segment, eliminating the potential for cholangitis, lithiasis and carcinoma.
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ranking = 2
keywords = duct
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9/67. Extrahepatic biliary schwannoma.

    Schwannoma (neurilemoma or neurinoma) rarely develops in the biliary tract. We report here a case of extrahepatic biliary schwannoma found in a 47-yr-old Japanese woman presenting with obstructive jaundice. The radiological imaging studies were suggestive of nonepithelial tumor involving the common bile duct. The patient underwent tumor resection. The tumor extended inward and outward from the wall of the common bile duct in the shape of a dumbbell. The extraductal tumor was solid with microcystic changes, while the intraductal lesion presented cystic changes. Microscopically, the tumor was predominantly composed of spindle-shaped cells with nuclear palisading, and it contained lymphoid aggregates. Immunohistochemically, the tumor cells were positive for S-100 protein. The final diagnosis was benign schwannoma of the common bile duct. The tumor differed from usual soft tissue schwannoma and closely resembled gastrointestinal schwannoma.
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ranking = 5
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10/67. Inflammatory myofibroblastic tumour of the extrahepatic bile ducts: an unusual cause of obstructive jaundice in children.

    Inflammatory myofibroblastic tumour is a rare entity in children with few reported series. The extrahepatic bile duct is an unusual location for this tumour. The authors report here the case of an 8-year-old girl presenting with obstructive jaundice due to inflammatory myofibroblastic tumour of the extrahepatic bile ducts with differential diagnosis of obstructive jaundice in children.
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ranking = 6
keywords = duct
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