RATIONALE Esophageal variceal bleeding caused by portal hypertension is massive and life-threatening to those patients with decompensated liver cirrhosis. A transjugular intrahepatic portosystemic shunt (TIPS) can effectively stop bleeding. But the process of puncture may lead to bile duct injury and even form fistulas between the hepatic artery and bile duct. PATIENT CONCERNS The case report...

Multiple studies have been conducted to demonstrate the role of viruses in causing biliary atresia. Although cytomegalovirus (CMV) is known to cause intrahepatic bile duct destruction, its role in biliary atresia is not proven. We report two cases of CMV infection, initially presenting with intrahepatic cholestasis, who subsequently developed biliary atresia.

hospital for thoracic spine metastasis. She had undergone embolization 8 years ago for hemobilia caused by a pseudoaneurysm in the right hepatic artery, which had developed after cholecystectomy with T-tube choledochostomy. Laboratory studies revealed alanine aminotransferase 510 IU/L, total/direct bilirubin 3.69/ 3.22mg/dL, alkaline phosphatase 496 U/L, and γ-glutamyltransferase 704 U/L. Abdom...

The diagnostic and therapeutic effectiveness of combined double-balloon endoscopy with a short endoscope and peroral direct cholangioscopy with an ultraslim endoscope in patients who have altered gastrointestinal anatomy has been demonstrated [1–5]. We describe successful biliary drainage with a short double-balloon endoscope and peroral direct cholangioscopy in a patient who had cholangitis af...

To evaluate the effectiveness and safety of simple resections of bile duct branch lesions for the treatment of regional hepatic bile duct stones.A retrospective analysis of the clinical data from patients in our hospital from November 2008 to November 2015, who only underwent a simple resection of the lesion bile duct branch. The patients' clinical characteristics, surgical features, postoperat...

Philips CA, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-221324 Description A 70-year-old male teetotaller, with a history of chronic obstructive lung disease and hypertension, presented to the emergency department with a 2-day history of right upper quadrant pain and melaena. Investigations revealed total bilirubin 6.8 mg/dL, aspartate and alanine transaminases 88 and 122 IU/L, respectively,...

The biliary trees descend from the canaliculi at the hepatocytes in the liver. Bile drains from this level into intrahepatic ducts, smaller ducts combine to form the segmental bile ducts which within the liver gradually enlarge and merge to the right and left hepatic ducts. The right and left hepatic ducts join together to form the common hepatic duct (CHD) at porta hepatis. The common bile duc...

Only a small percentage of patients with Hodgkin's disease become clinically Jaundiced during their disease. This Jaundice may be secondary to biliary obstruction, hemolysis, direct hepatic infiltration by the disease, drug toxicity or viral hepatitis. Vanishing bile duct syndrome secondary to Hodgkin's disease is a rare cause of cholestasis in these patients, only 13 cases having been reported...

BACKGROUND Lethal pancreatitis has been reported after treatment for common bile duct stones using small endoscopic papillary balloon dilation. METHODS We retrospectively evaluated the safety and efficacy of using large balloon dilation alone without the use of sphincterotomy for the treatment of large common bile duct stones in Kaohsiung Veterans General Hospital. Success rate of stone clear...

Bile duct tumor thrombus (BDTT) of a hepatocellular carcinoma (HCC) is a rare entity which was found microscopically in 1 to 9.2% of the resected specimen.A 54-year-old male was found to have a 65-mm hepatocellular carcinoma in segment VI of the liver with a huge intrahepatic bile duct tumor thrombus. As the main trunk of the posterior segment branched from the left bile duct, the BDTT of the p...