RESUMO
Hemorrhagic acalculous cholecystitis is an extremely rare but potentially fatal disease if detection is delayed. Its risk factors include critical illness, diabetes, malignant disease, uremia, and bleeding diathesis. This is the first case report in which hemorrhagic acalculous cholecystitis not accompanied by any risk factor. We herein present a case of hemorrhagic acalculous cholecystitis in a previously healthy patient who suffered from acute abdomen.
Assuntos
Adulto , Humanos , Masculino , Colecistite Acalculosa/complicações , Endoscopia Gastrointestinal , Vesícula Biliar/patologia , Cálculos Biliares/diagnóstico , Hemobilia/complicações , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
We report a case of small cell carcinoma of extrahepatic bile duct presenting with jaundice and hemobilia. A 59-year-old woman was admitted due to right upper quadrant pain and jaundice. An abdominal computed tomography revealed a 2 cm sized mass in the extrahepatic bile duct. Endoscopic retrograde cholangiopancreatography revealed bloody discharge coming out of the papillary orifice in endoscopic view and a dilated extrahepatic bile duct with multiple irregular filling defects in cholangiogram. A coronal T2-weighted image revealed a hyperintense mass at extrahepatic bile duct. Laparotomy was performed, and pathologic examination of resected specimen showed tumor cells having round to oval nuclei with coarsely granular chromatin and scanty cytoplasm, which were immunoreactive for synaptophysin and chromogranin A, compatible with the diagnosis of small cell carcinoma. The small cell carcinoma of bile duct, despite its rarity, should be considered in differential diagnosis of the causes for obstructive jaundice and hemobilia.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias dos Ductos Biliares/diagnóstico , Ductos Biliares Extra-Hepáticos/patologia , Carcinoma de Células Pequenas/diagnóstico , Colangiopancreatografia Retrógrada Endoscópica , Cromogranina A/metabolismo , Hemobilia/complicações , Imageamento por Ressonância Magnética , Sinaptofisina/metabolismo , Tomografia Computadorizada por Raios XRESUMO
Hemobilia following liver biopsy is rare and acute pancreatitis associated with hemobilia in such a situation is rarer. We report a 55-year-old man with ulcerative colitis and hepatitis C-positive liver disease who developed acute pancreatitis following liver biopsy. Surgical removal of blood clots from the biliary tree led to recovery.
Assuntos
Doença Aguda , Biópsia/efeitos adversos , Colite Ulcerativa/complicações , Hemobilia/complicações , Hepatite C/complicações , Humanos , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Pancreatite/etiologiaRESUMO
A hemobilia é causada incomum de hemorragia digestiva alta e está relacionada principalmente a traumatismos e procedimentos diagnósticos/terapêuticos no fígado. As causas näo traumáticas säo de ocorrência rara, sendo o colecistite aguda, associada ou näo à doença litiásica, uma possível fonte de sangramento. Os autores apresentam um caso de sangramento digestivo acentuado associado à colecistite hemorrágica litiásica, onde a fonte de sangramento deveu-se à corrosäo da artéria cística por um grande cálculo impactado no infundíbulo. Observaram também, a presença de icterícia por obstruçäo da via biliar principal por coágulos. Säo discutidos os principais aspectos etiopatogênicos, diagnósticos e terapêuticos desta afecçäo
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Colecistite/complicações , Hemobilia/etiologia , Colecistite/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemobilia/complicações , Hemobilia/cirurgiaRESUMO
A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.
Assuntos
Feminino , Humanos , Colestase Extra-Hepática/etiologia , Biópsia , Carcinoma Hepatocelular/complicações , Ducto Colédoco/patologia , Hemobilia/complicações , Cirrose Hepática/diagnóstico , Neoplasias Hepáticas , Pessoa de Meia-IdadeRESUMO
A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.