1.Overlap syndrome in autoimmune liver diseases.
Chinese Journal of Hepatology 2005;13(1):74-76
3.A Case of Congenital Hepatic Fibrosis Presented with Symptom of Acute Cholangitis.
Chang Soo CHOI ; Hyo Jeong OH ; Byung Soo KIM ; Eun Young JO ; Tae Hyeon KIM ; Suck Chei CHOI ; Haak Cheoul KIM ; Ki Jung YUN
The Korean Journal of Gastroenterology 2005;46(3):237-241
Congenital hepatic fibrosis (CHF) is an autosomal recessive disease, presenting principally in children or young adults with portal hypertension, and infrequently associated with cholangitis. It is associated with renal malformation and Caroli's disease. The diagnosis of CHF is usually confirmed by its typical histological features. Cholangitis is a severe and frequently fatal complication. We report a 22-year-old man with congenital hepatic fibrosis who showed the cholangitis without radiological features of cystic dilatation or stone of intrahepatic ducts.
Acute Disease
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Adult
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Cholangitis/*complications/diagnosis
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Humans
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Liver Cirrhosis/*complications/*congenital/diagnosis
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Male
5.A Case of Portal Vein Thrombosis Associated with Acute Pancreatitis and Cholangitis.
Dae Young CHEUNG ; Jae Kwang KIM ; Don Hyoun JO ; Hyun Jong OH ; Tae Ho KIM ; So Yeon LEE ; Soo Heon PARK ; Joon Yeol HAN ; Kyu Won CHUNG ; Hee Sik SUN
The Korean Journal of Gastroenterology 2005;46(1):60-65
Portal vein thrombosis is a rare complication accompanied with acute pancreatitis or cholangitis/cholecystitis. The main pathogenesis of portal vein thrombosis in pancreatitis or cholangitis/cholecystitis are suggested to be venous compression by pseudocyst and an imbalance between the blood coagulation and fibrinolysis. In this case report, we experienced a 63 year old male who developed portal vein thrombosis later in the course of the treatment of acute gallstone pancreatitis with cholangitis/cholecystitis without any symptom or sign. The diagnosis of portal vein thrombosis was given on follow up CT scan and serum protein S activity was decreased to 27% in laboratory study. Immediate anticoagulation therapy with heparin and thrombolytic therapy with urokinase and balloon dilatation were performed. Despite the aggressive treatment, complete reperfusion could not be obtained. With oral warfarin anticoagulation, the patient showed no disease progression and was discharged. We report a case of portal vein thrombosis as a complication of acute pancreatitis and cholangitis/cholecystitis with a review of literatures.
Acute Disease
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Cholangitis/*complications/diagnosis
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Cholecystitis/complications
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Humans
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Male
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Middle Aged
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Pancreatitis/*complications/diagnosis
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*Portal Vein
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Tomography, X-Ray Computed
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Venous Thrombosis/diagnosis/*etiology
6.A Case of Congenital Hepatic Fibrosis Presented with Recurrent Acute Cholangitis.
Shin Young LEE ; Hye Jin JOO ; Young Shim CHO ; Won Joong JEON ; Hee Bok CHAE ; Seon Mee PARK ; Sei Jin YOUN ; Rohyun SUNG
The Korean Journal of Gastroenterology 2009;54(6):404-408
Acute cholangitis usually develops in congenital hepatic fibrosis (CHF), accompanied by cystic dilated bile ducts. However, it can also develop in simple CHF and may lead to critical course. A 30-year old man presented with recurrent acute cholangitis without bile duct dilatation. He visited the hospital for febrile sense and abdominal pain in the right upper quadrant. He had been admitted several times for hepatosplenomegaly and cholangitis since childhood and received a liver biopsy 15 years ago. Abdominal computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) revealed hepatosplenomegaly and a mildly dilated bile duct without stones or biliary cysts. His condition improved after conservative treatment. However, during a two-month follow up period, the patient experienced three episodes of acute cholangitis. A liver biopsy was performed and showed periportal fibrosis and intrahepatic ductular dysplasia, characteristics of congenital hepatic fibrosis. The periportal fibrosis and the infiltration of inflammatory cells were aggravated compared to 15 years ago. There was no evidence of hepatic cirrhosis. He was diagnosed with congenital hepatic fibrosis with recurrent acute cholangitis without intrahepatic duct dilatation, and conservatively treated with antibiotics.
Acute Disease
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Adult
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Cholangiopancreatography, Endoscopic Retrograde
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Cholangitis/complications/*diagnosis
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Humans
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Liver Cirrhosis/complications/*congenital/pathology
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Male
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Recurrence
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Tomography, X-Ray Computed
7.Portal inflammation and bile ductular proliferation.
Chinese Journal of Pathology 2006;35(11):695-696
Antigens, CD1
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metabolism
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Child, Preschool
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Cholangitis, Sclerosing
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diagnosis
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etiology
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metabolism
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Diagnosis, Differential
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Female
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Histiocytosis, Langerhans-Cell
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complications
;
metabolism
;
pathology
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Humans
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Immunohistochemistry
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Liver
;
metabolism
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pathology
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S100 Proteins
;
metabolism
8.Liver Flukes: the Malady Neglected.
Korean Journal of Radiology 2011;12(3):269-279
Liver fluke disease is a chronic parasitic inflammatory disease of the bile ducts. Infection occurs through ingestion of fluke-infested, fresh-water raw fish. The most well-known species that cause human infection are Clonorchis sinensis, Opisthorchis viverrini and Opisthorchis felineus. Adult flukes settle in the small intrahepatic bile ducts and then they live there for 20-30 years. The long-lived flukes cause long-lasting chronic inflammation of the bile ducts and this produces epithelial hyperplasia, periductal fibrosis and bile duct dilatation. The vast majority of patients are asymptomatic, but the patients with heavy infection suffer from lassitude and nonspecific abdominal complaints. The complications are stone formation, recurrent pyogenic cholangitis and cholangiocarcinoma. Approximately 35 million people are infected with liver flukes throughout the world and the exceptionally high incidence of cholangiocarcinoma in some endemic areas is closely related with a high prevalence of liver fluke infection. Considering the impact of this food-borne malady on public health and the severe possible clinical consequences, liver fluke infection should not be forgotten or neglected.
Animals
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Bile Duct Neoplasms/*diagnosis/epidemiology/*parasitology
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Bile Ducts, Intrahepatic/*parasitology
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Biological Markers/analysis
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Cholangiocarcinoma/*diagnosis/epidemiology/*parasitology
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Cholangitis/diagnosis/parasitology
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Clonorchiasis/*complications/*diagnosis/epidemiology/parasitology
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Clonorchis sinensis
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Humans
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Incidence
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Opisthorchiasis/*complications/*diagnosis/epidemiology/parasitology
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Opisthorchis
9.Lemmel's Syndrome, an Unusual Cause of Abdominal Pain and Jaundice by Impacted Intradiverticular Enterolith: Case Report.
Hyo Sung KANG ; Jong Jin HYUN ; Seung Young KIM ; Sung Woo JUNG ; Ja Seol KOO ; Hyung Joon YIM ; Sang Woo LEE
Journal of Korean Medical Science 2014;29(6):874-878
Duodenal diverticula are detected in up to 27% of patients undergoing upper gastrointestinal tract evaluation with periampullary diverticula (PAD) being the most common type. Although PAD usually do not cause symptoms, it can serve as a source of obstructive jaundice even when choledocholithiasis or tumor is not present. This duodenal diverticulum obstructive jaundice syndrome is called Lemmel's syndrome. An 81-yr-old woman came to the emergency room with obstructive jaundice and cholangitis. Abdominal CT scan revealed stony opacity on distal CBD with CBD dilatation. ERCP was performed to remove the stone. However, the stone was not located in the CBD but rather inside the PAD. After removal of the enterolith within the PAD, all her symptoms resolved. Recognition of this condition is important since misdiagnosis could lead to mismanagement and therapeutic delay. Lemmel's syndrome should always be included as one of the differential diagnosis of obstructive jaundice when PAD are present.
Abdominal Pain
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Aged, 80 and over
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Cholangiopancreatography, Endoscopic Retrograde
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Cholangiopancreatography, Magnetic Resonance
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Cholangitis/complications
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Diverticulum
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Duodenal Diseases/complications/*diagnosis
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Female
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Fluoroscopy
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Gallstones/diagnosis/therapy
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Humans
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Jaundice, Obstructive/*complications
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Tomography, X-Ray Computed
10.Pathologic diagnosis of biliary intraepithelial neoplasia of liver.
Chinese Journal of Pathology 2007;36(11):781-784