ABSTRACT
In the past, most hepatolithiasis had been brown pigment stones in Korea. However, stones with high cholesterol content are found with increasing frequency. Abdominal ultrasonography is superior to CT for detection of cholesterol hepatolithiasis. The characteristic gross morphology of pure cholesterol hepatolithiasis shown by cholangioscopy is diagnostic. An effective medical management consists of stone removal by percutaneous transhepatic cholangioscopy and ursodeoxycholic acid for the prevention of recurrence. We here report a case of primary pure cholesterol hepatolithiasis with a review of the literature. A 29-year-old woman presented with right upper quadrant pain. Abdominal ultrasonography showed right intrahepatic duct stones. A cholangioscopy revealed typical cholesterol stones, mucosal hyperemia, and mild narrowing in stone-bearing intrahepatic duct. Cholangioscopic stone removal via the percutaneous transhepatic route was successfully performed. To prevent recurrence, ursodeoxycholic acid was administered.
Subject(s)
Adult , Female , Humans , Cholesterol , Hyperemia , Korea , Recurrence , Ultrasonography , Ursodeoxycholic AcidABSTRACT
Acute recurrent pancreatitis results most commonly from gallstone disease. Although transabdominal ultrasound is a common procedure for evaluating biliary tract, it may not be effective in minilithiasis. We here report a case of acute recurrent pancreatitis, in which endoscopic ultrasonography revealed minilithiasis in the gallbladder with a review of the literature. A 57-year-old woman had suffered from idiopathic recurrent pancreatitis four times for the past 4 months. While transabdominal ultrasonography and abdominal computerized tomography revealed no evidence of bliary stones, but EUS exhibited minilithiasis in the gallbladder. After laparoscopic cholecystectomy, no further events of pancreatitis happened.
Subject(s)
Female , Humans , Middle Aged , Biliary Tract , Cholecystectomy, Laparoscopic , Endosonography , Gallbladder , Gallstones , Pancreatitis , UltrasonographyABSTRACT
Acute recurrent pancreatitis results most commonly from gallstone disease. Although transabdominal ultrasound is a common procedure for evaluating biliary tract, it may not be effective in minilithiasis. We here report a case of acute recurrent pancreatitis, in which endoscopic ultrasonography revealed minilithiasis in the gallbladder with a review of the literature. A 57-year-old woman had suffered from idiopathic recurrent pancreatitis four times for the past 4 months. While transabdominal ultrasonography and abdominal computerized tomography revealed no evidence of bliary stones, but EUS exhibited minilithiasis in the gallbladder. After laparoscopic cholecystectomy, no further events of pancreatitis happened.
Subject(s)
Female , Humans , Middle Aged , Biliary Tract , Cholecystectomy, Laparoscopic , Endosonography , Gallbladder , Gallstones , Pancreatitis , UltrasonographyABSTRACT
Primary sclerosing cholangitis (PSC) is a rare disease entity. The medical therapy for PSC has not been reasonably beneficial. Thus liver transplantation is known to be the ultimate therapy. Because liver transplantation for PSC has been performed rarely in Korea, we report a case of liver transplantation for PSC with a review of the literature. A 35-year-old male was admitted to our hospital with recurrent jaundice for seven years. ERCP showed multiple strictures of intrahepatic duct and an irregularity of the extrahepatic duct wall. Despite medication and endoscopic treatment, liver functions did not imporve and clinical status got worsened. Thus liver transplantation was performed for the correction of hepatic failure. Two months after transplantation, liver functions and general weakness gradually improved and now, one year after liver transplantation, the patient is in normal life.