RESUMO
The research was performed at the Loginov Moscow Clinical Scientific Center. It is based on Russian obstructive jaundice (OJ) consensus results, considered at the 45th annual Central Research Institute of Gastroenterology Scientific session Oncological issues in the gastroenterologist practice (1 March 2019). The article objective is to note the diagnostic and conservative treatment current issues in patients with OJ. The increase in the number of patients with OJ of different etiology provides problem actuality. In a large number of cases, medical treatment is delayed due to inadequate diagnostic and management, while correct patients routing today can be provided regardless of medical institution level. In this article the examination steps and conservative treatment role in patients with biliary obstruction management are presented.
RESUMO
The paper gives information on current approaches to diagnosing and treating intrahepatic cholangiocarcinoma (IHC), its microscopic and macroscopic varieties. It details the specific features of images of IHC by ultrasonography, X-ray computed tomography, magnetic resonance imaging (MRI), including those by diffusion-weighted MRI. Dynamic intravenous contrast enhancement and analysis of tumor hemodynamic features are emphasized to play a crucial role in different examination (arterial, venous, and delayed) phases. Diffuse heterogeneous enhancement of the whole volume of the tumor in the arterial phase with pronounced peripheral and progressing centripetal enhancement in ensuing phases is considered to be the most common type of an IHC image, which can recognize with confidence this comparatively rare neoplasm.
