A case report of intraoperatively diagnosed holangiocarcinoma after unsuccessful conservative treatment of ERCP complicated with hemorrhage

Bozinovska Beaka, Gordana and Prgova Veljanovska, Biljana and Zdravkovska, Milka and Burova, Blagica (2018) A case report of intraoperatively diagnosed holangiocarcinoma after unsuccessful conservative treatment of ERCP complicated with hemorrhage. Lietuvos Chirurgija / Lithuanian Surgery, 17 (3-4). pp. 256-263. ISSN 1392–0995 ; 1648–9942 (online)

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Abstract

We present one case with cholangiocarcinoma diagnosed after surgical treatment of hemorrhage as post procedural complication from ERCP. With MRCP intraluminal stenosis of the upper part of common bile duct has been noticed and suspicious presence of substrate with consecutive dilatation of the upper billiary tract. ERCP was performed and sphincterotomy have been made without evacuation of any intraluminal substrate from common bile duct. Insufficient ERCP cholangiography was made and biopsy of the part with stenosis could not be taken due to permanent bleeding from performed sphincterotomy. Despite all attempts for conservative treatment of the hemorrhage, patient was still with permanent decreases of hemoglobin levels and with persistent hemorrhagic anemia. With decision from medical council the patient has been transferred to the Department of abdominal surgery for further immediate surgical treatment. Conclusion:Patient with extrahepatic bile duct carcinoma initially diagnosed as a calculus in the common bile duct. Looking back, the patient had symptoms which differential diagnosis for bile duct cholangiocarcinoma should be established. Clinical symptoms such as right hypochondrium pain, itchy skin, vomiting and diarrhea. The laboratory findings showed constantly elevated bilirubin and liver enzymes also elevated tumor markers as CA19-9 and CEA. Hemorrhage that occurs after ERCP sphincterotomy and attempt for biopsy could not been controlled with conservative measures. Patient with consequently caused hemorrhagic anemia has been transferred for surgical treatment, which stopped the bleeding, made final diagnosis and treatment of proximal stenosis of common bile duct. Key words: cholangiocarcinoma, ERCP hemorrhage, billiary stenosis.

Item Type: Article
Subjects: Medical and Health Sciences > Basic medicine
Medical and Health Sciences > Clinical medicine
Medical and Health Sciences > Health sciences
Divisions: Faculty of Medical Science
Depositing User: Milka Zdravkovska
Date Deposited: 01 Feb 2019 10:07
Last Modified: 02 Apr 2019 08:27
URI: http://eprints.ugd.edu.mk/id/eprint/21238

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