Acute cholangitis secondary to a common bile duct adenoma

Horng Yuan Lou, Chuno Chao Chang, Sheng-Hsuan Chen, Chia Lang Fang, Yao Hsu Shih, Jean-Dean Liu, Shiann Pan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

We report a case of distal common bile duct adenoma presenting with acute cholangitis. A 47-year-old woman suffered from right upper abdominal pain with persistent fever for 4 days. Abdominal ultrasonography showed mild dilatation of common bile duct and bilateral intrahepatic ducts. Endoscopic retrograde cholangiopancreatography disclosed a fixed filling defect in the distal common bile duct. Transpapillary biopsy and brush cytology was performed after sphincterotomy. The biopsy specimen showed adenomatous change with dysplasia and negative stain for p53. No significant regional lymph node enlargement was found on computed tomography. The patient subsequently received exploratory laparotomy and sphincteroplasty with excision of the distal common bile duct tumor. Finally, the tumor was diagnosed as common bile duct tubular adenoma with moderate nuclear dysplasia. Postoperatively, the patient had an uneventful course and has been well at follow-up for 8 months. We encountered a rare case of common bile duct adenoma in which malignant change was hard to rule out. We propose that sphincterotomy with biopsy is crucial before operation and p53 immunohistochemical staining is valuable for determining whether or not malignant change occurs in this borderline tumor.

Original languageEnglish
Pages (from-to)949-951
Number of pages3
JournalHepato-Gastroenterology
Volume50
Issue number52
Publication statusPublished - Jul 2003

Fingerprint

Bile Duct Adenoma
Cholangitis
Common Bile Duct
Biopsy
Neoplasms
Women's Rights
Endoscopic Retrograde Cholangiopancreatography
Laparotomy
Abdominal Pain
Cell Biology
Dilatation
Ultrasonography
Fever
Coloring Agents
Lymph Nodes
Tomography
Staining and Labeling

Keywords

  • Cholangitis
  • Common bile duct adenoma
  • p53

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Acute cholangitis secondary to a common bile duct adenoma. / Lou, Horng Yuan; Chang, Chuno Chao; Chen, Sheng-Hsuan; Fang, Chia Lang; Shih, Yao Hsu; Liu, Jean-Dean; Pan, Shiann.

In: Hepato-Gastroenterology, Vol. 50, No. 52, 07.2003, p. 949-951.

Research output: Contribution to journalArticle

@article{283c69bcea664f84b4026d1f58e388e4,
title = "Acute cholangitis secondary to a common bile duct adenoma",
abstract = "We report a case of distal common bile duct adenoma presenting with acute cholangitis. A 47-year-old woman suffered from right upper abdominal pain with persistent fever for 4 days. Abdominal ultrasonography showed mild dilatation of common bile duct and bilateral intrahepatic ducts. Endoscopic retrograde cholangiopancreatography disclosed a fixed filling defect in the distal common bile duct. Transpapillary biopsy and brush cytology was performed after sphincterotomy. The biopsy specimen showed adenomatous change with dysplasia and negative stain for p53. No significant regional lymph node enlargement was found on computed tomography. The patient subsequently received exploratory laparotomy and sphincteroplasty with excision of the distal common bile duct tumor. Finally, the tumor was diagnosed as common bile duct tubular adenoma with moderate nuclear dysplasia. Postoperatively, the patient had an uneventful course and has been well at follow-up for 8 months. We encountered a rare case of common bile duct adenoma in which malignant change was hard to rule out. We propose that sphincterotomy with biopsy is crucial before operation and p53 immunohistochemical staining is valuable for determining whether or not malignant change occurs in this borderline tumor.",
keywords = "Cholangitis, Common bile duct adenoma, p53",
author = "Lou, {Horng Yuan} and Chang, {Chuno Chao} and Sheng-Hsuan Chen and Fang, {Chia Lang} and Shih, {Yao Hsu} and Jean-Dean Liu and Shiann Pan",
year = "2003",
month = "7",
language = "English",
volume = "50",
pages = "949--951",
journal = "Acta hepato-splenologica",
issn = "0172-6390",
publisher = "H.G.E. Update Medical Publishing Ltd.",
number = "52",

}

TY - JOUR

T1 - Acute cholangitis secondary to a common bile duct adenoma

AU - Lou, Horng Yuan

AU - Chang, Chuno Chao

AU - Chen, Sheng-Hsuan

AU - Fang, Chia Lang

AU - Shih, Yao Hsu

AU - Liu, Jean-Dean

AU - Pan, Shiann

PY - 2003/7

Y1 - 2003/7

N2 - We report a case of distal common bile duct adenoma presenting with acute cholangitis. A 47-year-old woman suffered from right upper abdominal pain with persistent fever for 4 days. Abdominal ultrasonography showed mild dilatation of common bile duct and bilateral intrahepatic ducts. Endoscopic retrograde cholangiopancreatography disclosed a fixed filling defect in the distal common bile duct. Transpapillary biopsy and brush cytology was performed after sphincterotomy. The biopsy specimen showed adenomatous change with dysplasia and negative stain for p53. No significant regional lymph node enlargement was found on computed tomography. The patient subsequently received exploratory laparotomy and sphincteroplasty with excision of the distal common bile duct tumor. Finally, the tumor was diagnosed as common bile duct tubular adenoma with moderate nuclear dysplasia. Postoperatively, the patient had an uneventful course and has been well at follow-up for 8 months. We encountered a rare case of common bile duct adenoma in which malignant change was hard to rule out. We propose that sphincterotomy with biopsy is crucial before operation and p53 immunohistochemical staining is valuable for determining whether or not malignant change occurs in this borderline tumor.

AB - We report a case of distal common bile duct adenoma presenting with acute cholangitis. A 47-year-old woman suffered from right upper abdominal pain with persistent fever for 4 days. Abdominal ultrasonography showed mild dilatation of common bile duct and bilateral intrahepatic ducts. Endoscopic retrograde cholangiopancreatography disclosed a fixed filling defect in the distal common bile duct. Transpapillary biopsy and brush cytology was performed after sphincterotomy. The biopsy specimen showed adenomatous change with dysplasia and negative stain for p53. No significant regional lymph node enlargement was found on computed tomography. The patient subsequently received exploratory laparotomy and sphincteroplasty with excision of the distal common bile duct tumor. Finally, the tumor was diagnosed as common bile duct tubular adenoma with moderate nuclear dysplasia. Postoperatively, the patient had an uneventful course and has been well at follow-up for 8 months. We encountered a rare case of common bile duct adenoma in which malignant change was hard to rule out. We propose that sphincterotomy with biopsy is crucial before operation and p53 immunohistochemical staining is valuable for determining whether or not malignant change occurs in this borderline tumor.

KW - Cholangitis

KW - Common bile duct adenoma

KW - p53

UR - http://www.scopus.com/inward/record.url?scp=0037663714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037663714&partnerID=8YFLogxK

M3 - Article

C2 - 12845956

AN - SCOPUS:0037663714

VL - 50

SP - 949

EP - 951

JO - Acta hepato-splenologica

JF - Acta hepato-splenologica

SN - 0172-6390

IS - 52

ER -