Die primar-sklerosierende Cholangitis. [Primary sclerosing cholangitis]

Details

Serval ID
serval:BIB_E3EB14A13858
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Die primar-sklerosierende Cholangitis. [Primary sclerosing cholangitis]
Journal
Deutsche Medizinische Wochenschrift
Author(s)
Grune  S., Mullhaupt  B., Moradpour  D., Munch  R., Siegenthaler-Zuber  G., Siegenthaler  W.
ISSN
0012-0472 (Print)
Publication state
Published
Issued date
07/1991
Volume
116
Number
28-29
Pages
1095-100
Notes
Case Reports
English Abstract
Journal Article --- Old month value: Jul 12
Abstract
In a 40-year-old patient unexplained recurrent attacks of epigastric colic with transient cholestatic icterus occurred over a 9-year period. When the patient was again hospitalised because of progressive pain-free icterus associated with mild pruritus (alkaline phosphatase 900 U/l, direct bilirubin 305 mumol/l, GOT 187 U/l, GPT 103 U/l) sonography revealed liver enlargement to 17 cm, extended intrahepatic bile ducts and an echodense area of about 1 cm size in the region of the bifurcation of the common hepatic duct. Fine-needle puncture did not yield clear cytological findings. Endoscopic retrograde cholangiopancreatography pointed to sclerosing cholangitis. This diagnosis was confirmed by liver punch biopsy. Since the patient did not agree to a liver transplantation, he was treated with 450 mg ursodeoxycholic acid twice daily, resulting in marked reduction of the liver parameters until severe cholangiosepsis and acute renal failure occurred about 4 months later. The septic condition and its complications could not be managed despite thorough intensive-care measures so that a liver transplant had to be performed after all. Histology of the explantate revealed a cholangiocarcinoma in the region of the bifurcation of the common hepatic duct. At first the patient's condition improved markedly but one and half months later the transplant was rejected and the patient died.
Keywords
Adenoma, Bile Duct/diagnosis Adult Bile Duct Neoplasms/diagnosis Cholangiopancreatography, Endoscopic Retrograde *Cholangitis, Sclerosing/diagnosis/therapy Diagnosis, Differential Hepatic Duct, Common Humans Liver Transplantation Male Prognosis Ursodeoxycholic Acid/therapeutic use
Pubmed
Web of science
Create date
25/01/2008 16:05
Last modification date
20/08/2019 16:07
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