Tumor fragment impacted at the major duodenal papilla causing obstructive jaundice in a patient with hepatocellular carcinoma - 23/08/11
Doi : 10.1016/j.gie.2008.04.023
Noritoshi Kobayashi, MD, Hiroyuki Kirikoshi, MD, Takuma Higurashi, MD, Hiroshi Iida, MD, Hironori Mawatari, MD, Hiroki Endo, MD, Yuichi Nozaki, MD, Kyoko Yoneda, MD, Tomoyuki Akiyama, MD, Koji Fujita, MD, Masato Yoneda, MD, Hirokazu Takahashi, MD, Yasunobu Abe, MD, Masahiko Inamori, MD, Kensuke Kubota, MD, Satoru Saito, MD, Norio Ueno, MD, Atsushi Nakajima, MD
Gastroenterology Division, Yokohama City University School of Medicine, Yokohama, Japan
| Commentary |
|
| Obstructive jaundice is an uncommon presentation of HCC, occurring in fewer than 10% of patients. Such obstruction may be caused by tumor infiltration, duct compression, and tumor casts or blood clots within the ductal system. In some cases of hemobilia, the diagnosis of HCC is only made after histologic evaluation of the blood clot reveals it to contain HCC cells. TACE understandably may increase the possibility of common bile duct obstruction because it allows bits of the tumor to fragment off the main mass when it becomes necrotic. This case echoes Virgil’s prescient statement aegrescit medendo (the disease worsens with treatment), although advances in treatment subsequent to his time (70-19 B.C.E.) have enabled us to treat the complications of our treatments, albeit with the potential for further complications. And so it goes…. |
|
| Lawrence J. Brandt, MD |
|
| Associate Editor for Focal Points |
© 2008
American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 68 - N° 5
P. 999-1000 - novembre 2008 Retour au numéro
Article précédent
- Gastric carcinoma presenting with adrenal insufficiency caused by bilateral adrenal metastasis
- Waheed Gul, Arif M. Qazi, Christopher Barde
- Acute abdomen: superior mesenteric artery occlusion
- Jin-Dong Kim, Kang-Moon Lee, Jeong-Rok Lee, Chang-Nyol Paik, Woo-Chul Chung
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?