[Caroli's disease: diagnostic problems and possibilities of treatment].

Caroli's disease is a rare congenital condition characterized by segmental non-obstructive fibrocystic dilation of intrahepatic bile ducts. Dilated ducts may be infected and contain stones. This review of the modern literature describes few known cases of the disease, analyses its clinical features and results of treatment. The principal diagnostic methods include visualization by ultrasound study, CT, MRT, retrograde and transhepatic cholangiography. Surgical intervention is the method of choice for the treatment of the disease including resection of liver, placement of hepatico-jejunal anastomoses and transplantation. The choice depends on the extent of the lesion and anticipated complications. The authors' observation of the patient with Caroli's disease in a 35 year-old woman is presented. It was successfully treated by left-hand bisegmentectomy even though the disease was diagnosed 14 years after the first symptoms. It is recommended that the disease, even if a rare one, should be included in the algorithm of differential diagnostics ofrecurrent abdominal pain with manifestations of cholestasis or fever of an unknown origin.

[Bone mineral density in patients with breast cancer in the perimenopausal period].

Dual-energy X-ray absorptiometry was used to examine 54 patients with breast cancer. A clinical comparison group comprised 50 healthy women. All the examinees were aged 45 to 55 years. Bone mineral density was measured in the lumbar spine, proximal femur, and ultradistal antibrachium. The X-ray densitometric values of bone tissues in perimenopausal women with breast cancer were not found to be abnormal, which led to the conclusion that there were no significant bone metabolic disturbances. Along with this it was established that the women at this age had considerably reduced bone mineral density in the epimetaphyseal (ultradistal) forearm with evolving osteopenia. In this connection, it is expedient to identify an ultradistal portion of the antibrachium as an object of X-ray densitometric examination for the early diagnosis of impaired bone mineralization in women in the 45-to-55-year-old age group.

[X-ray densitometric characteristics of bone mineral density in patients with impaired biliation].

Dual-energy X-ray absorptiometry was used to examine 20 patients with obstructive jaundice, who had undergone external biliary drainage in the first surgical stage. A clinical comparison group comprised 34 patients without hepatobiliary diseases. Bone mineral density was measured in the lumbar spine, proximal femur, and ultradistal antibrachium. Impaired biliation was found to result in bone loss in the early-stage of the disease, which was more marked in the spongy bone. This allows the ultradistal antibrachium to be identified as a main observation area for dual-energy X-ray absorptiometry to make an early diagnosis of mineralization disorders. The integrated T index (Tint) calculated on the basis of the X-ray densitometry of a few skeletal portions may be used to obtain generalized information on bone mineral density.