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Test Paper 6
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
The sonographic findings of an impacted gallstone within the neck of bladder causing proximal biliary dilatation are diagnostic for Mirizzi syndrome. Mirizzi syndrome is caused by impaction of a large gallstone in the cystic duct, cystic duct remnant or gallbladder neck. The impacted stone causes external compression of the CBD, resulting in proximal dilation of the biliary tree. A choledochocoele is cystic dilatation of the CBD within the lumen of the duodenum. Caroli disease is a congenital disorder characterised by saccular dilatations of intrahepatic ducts. Caroli disease, in association with congenital hepatic fibrosis, polycystic kidney disease and others, is known as Caroli syndrome.
Diagnosis of echinococcosis by detecting circulating cell-free DNA and miRNA
Published in Expert Review of Molecular Diagnostics, 2023
Mahboubeh Hadipour, Majid Fasihi Harandi, Hossein Mirhendi, Hossein Yousofi Darani
The diagnosis of echinococcosis is mostly based on clinical findings, imaging and immunodiagnostic tests [8,9]. Clinical manifestations of echinococcosis are not specific and patients often develop symptoms in the later stages of the disease. Therefore, diagnosis of echinococcosis is difficult particularly in the early stages of the disease [10,11]. Due to its safety, low cost and rapid diagnostic abilities, ultrasound (US) is the most common technique used for diagnosis, follow-up, and screening of the disease [11,12]. According to the US classification developed by the World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE), CE cysts are classified into five types of CE1 to CE5, and AE lesions into different PNM stages i.e. Parasite lesions, Neighbor organs, and Metastases [8,9]. The US provides reliable information on the location, number, size, and stage of the cysts which are critical for the diagnosis of echinococcosis [8,13,14]. However, it cannot accurately distinguish Echinococcus cysts from other cysts such as liver abscesses, Caroli disease, bilomas, and cystadenomas [11,15–17] (Table 1). Therefore for appropriate diagnosis, using a combination of imaging and laboratory techniques is recommended [8].
Central Hepatic Regenerative Nodules in Alagille Syndrome: A Clinicopathological Review
Published in Fetal and Pediatric Pathology, 2021
Regenerative changes in the liver are not found exclusively in patients with Alagille syndrome. These lesions have been reported in other biliary anomalies including biliary atresia, Caroli disease/congenital hepatic fibrosis, progressive familial intrahepatic cholestasis type 1, Langerhans cell histiocytosis and primary sclerosing cholangitis [17, 19]. There is limited evidence to confirm the etiology of regenerative hepatic nodules. Rougemont and McLin [19] suggest that vascular abnormalities in cholestatic liver disorders cause preferential perfusion of central areas, resulting in maintenance of near-normal bile ducts in this region of the liver. Meanwhile, Libbrecht and Cassiman [20] and Roberts et al. [17] propose that the central bile ducts in Alagille syndrome (and other cholestatic processes) are intrinsically preserved, allowing for a reactive response, which occasionally forms a mass-like lesion. There is agreement that the pathogenesis of the central nodules seen in Alagille syndrome and other cholestatic conditions are reactive in nature as opposed to neoplastic [17, 19, 20].
Should patients with symptomatic cholelithiasis before 30 years of age be tested for ABCB4 gene mutations?
Published in Scandinavian Journal of Gastroenterology, 2020
Catarina Gouveia, Margarida Flor de Lima, Flávio Pereira, Bruno Rosa, José Cotter, António Banhudo, Maria Duarte, Alexandre Ferreira, Marília Cravo, Joana Nunes
Symptomatic cholelithiasis was defined as the presence of biliary symptoms (biliary pain, acute cholecystitis, acute pancreatitis, acute cholangitis) in association with evidence of gallbladder or common bile duct lithiasis or sludge. Diagnose of LPAC syndrome was made when at least two of the following characteristics were present: biliary symptoms with onset before 40 years of age; symptom recurrence after cholecystectomy; presence of liver echogenic foci suggestive of intrahepatic lithiasis; past history of intrahepatic cholestasis of pregnancy, and family history (first degree relatives) of gallstone disease, in patients with or without identified mutations. Patients with chronic cholestatic liver diseases (primary sclerosing cholangitis, primary biliary cholangitis, Caroli disease, congenital hepatic fibrosis, Osler–Weber–Rendu disease, cystic fibrosis, porphyria), Crohn’s disease and chronic hemolysis were excluded from this study. Patients’ clinic and demographic data were collected.