GASTROINTESTINAL ENDOSCOPY S165 Gallstones are extremely common in Western societies. Approximately l5% of Americans have gallstones, and approximately 650,000 to 700,000 cholecystectomies are performed every year.1. More than 98% of all biliary tract disorders are in some way related to gallstones. Symptoms and complications related to gallstones are among the most costly digestive disorders, ...

Low phospholipid-associated cholelithiasis (LPAC) is characterized by the association of ABCB4 mutations and low biliary phospholipid concentration with symptomatic and recurring cholelithiasis. This syndrome is infrequent and corresponds to a peculiar small subgroup of patients with symptomatic gallstone disease. The patients with the LPAC syndrome present typically with the following main fea...

Vanishing Bile Duct Syndrome (VBDS) refers to the group of acquired disorders associated with progressive destruction and disappearance of the intrahepatic bile ducts and, ultimately, cholestasis. This is a final common pathologic pathway, resulting from multiple etiologies including autoimmune disorders, medications, genetic abnormalities, infectious diseases, and neoplastic disorders.1 Variou...

Figure 2. Magnification ( 400) of figure 1, showing the eggs within the uterus of Clonorchis sinenis. Figure 1. Micrograph of a liver biopsy specimen from the patient’s explanted liver showing Clonorchis sinensis in intrahepatic biliary ducts, with labeled structures. A, Intrahepatic bile duct; B, C. sinensis uterus filled with eggs; C, seminal receptacle; D, cecum; E, vitellaria. (Hematoxylin ...

Several species of Helicobacter colonize the hepatobiliary tract of animals and cause hepatobiliary diseases. The aim of this study is to investigate Helicobacter found in the biliary tract diseases of humans. Thirty-two bile samples (15 from bile duct cancer, 6 from pancreatic head cancer, and 11 from intrahepatic duct stone) were obtained by percutaneous transhepatic biliary drainage. Polymer...

Primary adenosquamous cell carcinoma of the liver, a variant of cholangiocarcinoma is very rare disease and its prognosis is known to be very poor. We describe here a case of primary adenosquamous carcinoma of the liver. The patient was a 60-year-old woman who complained of an eight-month history of intermittent upper abdominal pain. Abdominal computed tomography scan revealed a low density mas...

Caroli disease (CD) is a rare congenital malformation of the liver characterized by non-obstructive, segmental, cystic dilatation of the intrahepatic bile ducts (IHDs). The clinical course is usually asymptomatic for the first 5-20 years, and symptoms may seldom occur throughout the patient's life. Bile stagnation leads to recurrent episodes of cholangitis, stone formation, or liver abscesses, ...

A 65-year-old woman developed chronic renal failure of unknown etiology and required hemodialysis. She was scheduled to undergo living-related renal transplantation from her husband. However, a cystic lesion of the liver associated with calcification, gallstones, and dilatation of intrahepatic bile ducts (B2-B3) was found by the referring hospital. Investigation of the cystic tumor was performe...

A 65-year-old man presented with mildly elevated gamma-glutamyltranspeptidase (GGT) serum level on blood tests done for general check-up, and the finding of hepatomegaly and diffuse heterogeneity of the hepatic parenchyma on abdominal ultrasound. The patient’s history included essential hypertension treated with angiotensin converting enzyme-inhibitors. The patient had no other features of the ...

This is a 77 year old female with no medical history who presented to the emergency room with 48 hours of right hypochondrium abdominal pain, associated to conjunctive jaundice. The blood test showed elevated bilirubin and C reactive protein test. CT scan revealed gallbladder hydrops, dilated left intrahepatic bile duct, common bile duct (CBD) of 8 mm and left hepatic lobe atrophy (Fig. 1). The...