ABSTRACT
Development of an intraabdominal bile collection (biloma) usually occurs secondary to traumatic or iatrogenic injury including abdominal surgery, percutaneous catheter drainage, and transhepatic cholangiogram. We present a case of hepatic subcapsular biloma following endoscopic retrograde cholangiography and identified by ultrasound and computed tomodensitometry examinations. A percutaneous drainage procedure allowed a subsequent endoscopic retrograde cholangiopancreatography to be performed that documented the location and extent of the bile leak and led to resolution of the biloma.
Subject(s)
Bile , Cholangiopancreatography, Endoscopic Retrograde/adverse effects , Extravasation of Diagnostic and Therapeutic Materials/complications , Liver , Aged , Aged, 80 and over , Drainage , Female , Humans , Liver/diagnostic imaging , Liver/pathology , Tomography, X-Ray Computed , UltrasonographyABSTRACT
We report the case of a 66 year-old man who developed acute necrotizing pancreatitis. The usual etiologies of acute pancreatitis were easily excluded. Endoscopic retrograde cholangiopancreatography demonstrated a 10 mm diameter filling defect in the distal common bile duct. After endoscopic sphincterotomy, a polypoid tumour which appeared to arise from the common bile duct was delivered through the wound. Diathermic resection of the tumor was performed. Microscopic examination disclosed papillary adenoma, without histologic signs of malignancy. Follow-up was favorable.
Subject(s)
Common Bile Duct Neoplasms/complications , Cystadenoma/complications , Pancreatitis/etiology , Acute Disease , Aged , Common Bile Duct Neoplasms/surgery , Cystadenoma/surgery , Endoscopy , Humans , MaleABSTRACT
Histologic features of the gastric (antral and fundic) mucosa in 14 patients with portal hypertension due to alcoholic cirrhosis and a mosaic pattern of the fundic mucosa at endoscopic examination have been compared with those of the gastric mucosa in 14 control subjects. We attempted to correlate endoscopic and histologic aspects using a semiquantitative morphometric study in which the height of the mucosa, the number per mm2 and the diameter of vascular sections of the interglandular chorion, and the number per mm2 of large (greater than or equal to 20 micron) vascular sections of the superficial chorion were measured. For all parameters, the mean values were higher in cirrhotic patients than in controls, but significant differences were found only in the antral mucosa (height of the mucosa and number of large vascular sections in the superficial chorion). These results confirm the frequency and the importance of vascular abnormalities of the gastric mucosa in patients with portal hypertension, but do not explain, at least with the methodology used, the mosaic pattern of the fundic mucosa disclosed in most cirrhotic patients.
Subject(s)
Gastric Mucosa/pathology , Hypertension, Portal/pathology , Liver Cirrhosis, Alcoholic/complications , Biopsy , Female , Gastric Fundus/pathology , Gastric Mucosa/blood supply , Humans , Hypertension, Portal/etiology , Liver Cirrhosis, Alcoholic/pathology , Male , Middle Aged , Pyloric Antrum/pathologyABSTRACT
We report on the observation of a 26-year-old woman with portal vein obstruction, diagnosed at the age of 3, and liver iron overload. Celiac and superior mesenteric angiography showed large and multiple venous collaterals between the portal and caval systems. Liver biopsy demonstrated, on Perl's staining, an important hemosiderin deposition, confirmed by an increased hepatic iron concentration (15.6 mumol/100 mg dry weight). No other histologic abnormality was found. This report suggests that large spontaneous portosystemic shunting may stimulate hepatic iron deposition in an otherwise normal liver. This mechanism could, at least in part, explain the significant hepatic siderosis observed in some cirrhotic patients.
