Carcinoma ; complications ; therapy ; Cholangitis ; complications ; therapy ; Drainage ; Humans ; Semicircular Ducts

Aged ; Bile Ducts ; pathology ; Cholangitis ; complications ; Humans ; Jaundice ; complications ; Male

Cholangitis, Sclerosing ; complications ; Histiocytosis, Langerhans-Cell ; etiology ; Humans

Autoantibodies ; blood ; Cholangitis, Sclerosing ; complications ; diagnosis ; Hepatitis, Autoimmune ; complications ; diagnosis ; Humans ; Liver Cirrhosis, Biliary ; complications ; diagnosis

Autoantibodies ; Cholangitis, Sclerosing ; complications ; diagnosis ; Hepatitis, Autoimmune ; complications ; diagnosis ; Humans ; Liver Cirrhosis, Biliary ; complications ; diagnosis ; Syndrome

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 ; Adult ; Cholangitis/*complications/diagnosis ; Humans ; Liver Cirrhosis/*complications/*congenital/diagnosis ; Male

Adult ; China ; epidemiology ; Cholangitis, Sclerosing ; complications ; epidemiology ; Colitis, Ulcerative ; complications ; Female ; Humans ; Male ; Middle Aged

Ulcerative colitis is an idiopathic chronic inflammatory bowel disease and its incidence in Korea has rapidly increased over the past two decades. Since ulcerative colitis is associated with increased risk for colorectal cancer, annual or biannual colonoscopy with four quadrant random biopsies at every 10 cm segments has been recommended for surveillance of colitic cancer in patients with long standing left-sided or extensive colitis. Recent epidemiologic data and meta-analysis suggest that the increment of colorectal cancer risk in ulcerative colitis was not larger than that of previous studies. Moreover, in addition to the extent and duration of colitis, other risk factors such as family history of colorectal cancer, primary sclerosing cholangitis, stricture, pseudopolyps, and histologic severity of inflammation have been recognized. As a result, updated guidelines provide surveillance strategies adjusted to the individual patient's risk for colitic cancer. Regarding surveillance method, target biopsy under panchromoendoscopy is preferentially recommended rather than random biopsy.
Cholangitis, Sclerosing/complications ; Colitis, Ulcerative/*complications ; Colon/pathology ; Colorectal Neoplasms/epidemiology/*etiology ; Humans ; Inflammatory Bowel Diseases/complications ; Polyps ; Risk Factors

Cholangitis, Sclerosing ; complications ; diagnosis ; therapy ; Hepatitis, Autoimmune ; complications ; diagnosis ; therapy ; Humans ; Liver Cirrhosis, Biliary ; complications ; diagnosis ; therapy ; Syndrome

PURPOSE: After the excision of a choledochal cyst, late complications seldom develop. Herein, we propose a modified surgical classification, which allows surgeons to select an appropriate operation and minimize late postoperative complications. METHODS: A total of 90 Todani type I and IV cases were reviewed to examine the morphologic characteristics of choledochal cysts and to evaluate the clinical outcomes after cyst excision. The cysts were then reclassified based on factors determining the postoperative outcomes. RESULTS: There were 8 intrahepatic complications (4 cholangitis, 4 IHD stones) and 3 intrapancreatic complications (2 pancreatitis, 1 symptomatic remnant distal cyst). Seven of the 8 intrahepatic complications (87.5%) occurred in cases with IHD dilatation, 6 of which were associated with a ductal stricture or isolated intrahepatic cyst. Using the above factors as classification criteria, a modified surgical classification is proposed. Cases were classified as types I or IV cysts according to the presence of IHD dilatation. The type I cysts were further divided into types Ia and Ib according to the cyst multiplicity, and type IV cysts according to the pattern of continuity between the extra- and intrahepatic cyst: IHD dilatation without stricture, IVa; IHD dilatation with ductal stricture, IVb; isolated intrahepatic cyst, IVc. CONCLUSION: According to our classification, the extrahepatic approach is enough for types I, IVa and IVb to improve long-term outcome. For type IVc and some of type IVb with a stricture, where an extrahepatic approach is difficult, and hepatectomy should be combined.
Cholangitis ; Choledochal Cyst* ; Classification* ; Constriction, Pathologic ; Dilatation ; Hepatectomy ; Pancreatitis ; Postoperative Complications