RESUMEN
A 10 years old boy who was initially diagnosed as choledochal cyst underwent laparotomy. There was presence of necrotic and soft tissue growth within common bile duct (CBD). After extensive toileting of bile duct, a T-tube was placed. His histopathology followed by immunohistochemistry revealed Embryonal Rhabdomyosarcoma. Later the patient received VAC regime chemotherapy. On follow-up imaging, there was no tumour mass in CBD. So, T-tube removed and now the patient is doing well.
Asunto(s)
Rabdomiosarcoma Embrionario , Masculino , Humanos , Niño , Rabdomiosarcoma Embrionario/diagnóstico , Rabdomiosarcoma Embrionario/cirugía , Conducto Colédoco , NecrosisRESUMEN
Diagnosis of primary sclerosing cholangitis (PSC) is often very difficult and may have a suspicion with altered liver functions. PSC is known to be associated with inflammatory bowel disease. This article presents a case study of a 70 years old male patient who presented with obstructive jaundice with recurrent episode of cholangitis in June 2019 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Evaluation revealed beaded appearance in MRCP with positive relevant markers which raised suspicion of PSC and it was confirmed by biopsy and histopathology of the affected segment in biliary tree. The importance of early detection of primary sclerosing cholangitis in an effort to decrease the morbidity and mortality from cholangiocarcinoma will also be emphasized and our management according to local protocol and outcome of this patient.
Asunto(s)
Neoplasias de los Conductos Biliares , Colangitis Esclerosante , Ictericia Obstructiva , Humanos , Anciano , Ictericia Obstructiva/diagnóstico , Ictericia Obstructiva/etiología , Colangitis Esclerosante/complicaciones , Colangitis Esclerosante/diagnóstico , Bangladesh , Conductos Biliares IntrahepáticosRESUMEN
Hyperbilirubinemia is commonly seen in medical practice. But what could be the highest level of bilirubin in an individual that is still an unanswered question. We came across to a 37 years old lady in October 2018 with hepaticolithiasis who underwent extended choledocholithotomy. Her preoperative serum bilirubin was within normal range. Post-operatively she developed cholangitis and from 3rd post-operative day onwards she developed severe hyperbilirubinemia, which was high as 70.47 mg/dl on the 6th post-operative day. Other causes of post-operative hyperbilirubinemia were excluded. She was managed conservatively for this hyperbilirubinemia and bilirubin level gradually reduced.
