A Case of Biliary Cast Syndrome after Cadaveric Liver Transplantation / 대한소화기학회지
The Korean Journal of Gastroenterology
;
: 106-109, 2007.
Artigo
em Coreano
| WPRIM
| ID: wpr-15076
ABSTRACT
We experienced one fatal case of biliary cast syndrome after cadaveric liver transplantation involving both intrahepatic ducts. A 58-year-old man underwent cadaveric liver transplantation because of hepatitis B virus related liver cirrhosis and concomitant hepatocellular carcinoma. Five weeks after the liver transplantation, postoperative course was complicated by development of acute cholangitis. Subsequent endoscopic retrograde cholangiography revealed diffuse intrahepatic bile duct strictures without filling defects. Percutaneous liver biopsy, which was done to exclude rejection, revealed biliary cast. Successful endoscopic removal was precluded due to its diffuse involvement. Because of the deterioration of patient's condition by refractory biliary obstruction and cholangitis, retransplantation from cadaveric donor was performed. Debridement of the biliary tree after graft removal yielded a near-complete cast of the intrahepatic ductal system. Biliary cast syndrome should be suspected when jaundice or cholangitis is associated with dilated ducts on abdominal imaging studies in cadaveric liver transplantation recipients. Initial therapeutic options include removal of biliary cast after endoscopic or percutaneous cholangiography. Although endoscopic retrieval of biliary cast by endoscopic retrograde cholangiopancreatography could be employed as a first-line management, other modalities such as endoscopic nasobiliary drainage, percutaneous transhepatic drainage, or retransplantation should be considered when complete removal is not feasible and the condition of the recipient deteriorates.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Complicações Pós-Operatórias
/
Doenças dos Ductos Biliares
/
Ductos Biliares Intra-Hepáticos
/
Tomografia Computadorizada por Raios X
/
Colangiopancreatografia Retrógrada Endoscópica
/
Transplante de Fígado
/
Evolução Fatal
/
Ductos Biliares Extra-Hepáticos
/
Icterícia Obstrutiva
Limite:
Humanos
/
Masculino
Idioma:
Coreano
Revista:
The Korean Journal of Gastroenterology
Ano de publicação:
2007
Tipo de documento:
Artigo
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