Metastatic tumors of the duodenal papilla (ampulla of Vater) are rare. The images here are from a middle-aged gentleman with progressive cholestatic jaundice and recurrent cholangitis, with a past history of nephrectomy for renal cell carcinoma (RCC) 6 years earlier. Endoscopy revealed a bulky duodenal papilla, and the biopsy showed features consistent with RCC (Figs. 1 and 2). Metastatic tumor...

Autoimmune hepatitis is a heterogeneous liver disease of unknown etiology. It is predominant in females and characterized by elevation of transaminase, hypergammaglobulinemia and circulating autoantibodies. Interface hepatitis and plasma cell infiltration are the main findings on liver biopsy. However, deep cholestatic jaundice is rarely seen. We present here an unusual case of type 1 autoimmun...

Physical examination revealed severe jaundice. There were no signs of chronic liver disease. He was afebrile with a regular pulse rate of 100 beats per minute and normal blood pressure. He had no signs of thyroid eye disease and no external goiter. Respiratory and cardiovascular examinations were normal. Chest radiography and echocardiography excluded any kinds of cardiac failure. There was no ...

OBJECTIVE To review best practices for early recognition and treatment of conditions resulting in neonatal cholestasis, in order to improve long-term outcomes for affected infants. QUALITY OF EVIDENCE Studies, review articles, and meta-analyses pertaining to neonatal-onset cholestasis were sought via electronic databases. Reference lists of studies and review articles supplemented the electro...

A 46-year-old female was admitted to the hospital with jaundice and pruritus. The patient had no previous history of liver or biliary disease. She had no reported any drug use nor had she any history of cigarette smoking or drinking alcohol. In the physical exam, she had icterus in the sclera of her eyes, and no pathologic exam finding was observed other than mild painless hepatomegaly. There w...

Background: Biliary Atresia (BA) also known as "progressive obliterative cholangiopathy" is one of the most common conditions requiring pediatric liver transplant and surgically treatable cause neonatal cholestasis. Associated malformations are present in 25% cases it East Asia, with incidence reported high 5,000. BA presents cholestatic Jaundice, initially indistinguishable from physiological ...