Subject(s)
Hamartoma , Liver/abnormalities , Aged , Diagnosis, Differential , Female , Hamartoma/diagnosis , Humans , Middle Aged , PrognosisABSTRACT
A 63-year-old male complained of right upper abdominal pain and jaundice. Laboratory data on admission showed hyperbilirubinemia, elevation of biliary enzymes and an extraordinarily high value of serum CA19-9 (60,000 U/ml). Diagnostic imaging modalities including abdominal ultrasonogram, abdominal CT and PTC suggested a stone impaction of the common bile duct. Jaundice subsided after PTC-drainage in association with decreasing serum CA19-9 value, which returned to the normal level six weeks later. Spontaneous delivery of the stone via the fistula was confirmed by cholangiography through the drainage tube. Though there are few reports of such a high serum CA19-9 level, the possibility of benign biliary tract disease should be considered in patients showing an extraordinarily high serum CA19-9 value.
Subject(s)
Antigens, Tumor-Associated, Carbohydrate/blood , Cholangitis/immunology , Gallstones/immunology , Biomarkers , Cholangitis/complications , Cholangitis/diagnosis , Gallstones/complications , Gallstones/diagnosis , Humans , Male , Middle AgedABSTRACT
Effects of glucose (225 ml, 300 kcal) ingestion on hepatic hemodynamics was studied in ten patients with liver cirrhosis and eight patients with non cirrhotic liver disease by per-rectal portal scintigraphy using 99mTcO4- (direct intramural administration of radioisotope method). Initial portal blood flow index (IP) and collateral index (CI) were calculated from the time activity curve of heart and liver. The value of IP was not significantly changed between before and after glucose ingestion in cases with liver cirrhosis (before: 0.0160 +/- 0.0016, after: 0.204 +/- 0.106). In cases with non cirrhotic liver disease, the value of IP was significantly increased after glucose ingestion (before: 0.0381 +/- 0.0145, after: 0.0544 +/- 0.0194, p less than 0.02). These findings suggested increase in portal blood flow via inferior mesenteric vein to the cardiac blood flow. The value of CI before glucose ingestion was significantly increased in cases with liver cirrhosis (0.751 +/- 0.156) compared with that in cases with non cirrhotic liver disease (0.517 +/- 0.122), but no significant difference in values after glucose ingestion was found between these two groups.
