Intraductal papillary neoplasm in common bile duct opening into the stomach
ConclusionEctopic biliary drainage into the stomach is extremely rare, but its recognition may help identify the cause of certain clinical conditions and prevent bile duct injury during surgery if required.
Condition: Neonatal Jaundice Interventions: Drug: Fenofibrate; Drug: Placebo Sponsor: Mansoura University Completed
On 20 April 2020, WHO received information regarding a confirmed yellow fever case in Galangashie health area, located 30 km from Mango village, Oti district, Savanes region in the northern part of Togo. The case is a 55-year-old woman with no vaccination history for yellow fever. She had onset of symptoms on 31 January 2020 and presented to a health facility on 3 February 2020 with fever and aches. The following day she developed jaundice and a blood sample was taken. On 7 February , the blood sample was transported to the national laboratory. On 10 February , the sample from the case was received at the national laborato...
Investigational use of intravenous vitamin C has been on the rise, but its side effects may be underreported. A 75-year-old woman presented with acute onset of jaundice, dark urine and shortness of breath after receiving 30 g of vitamin C infusion as an unconventional therapy for her hemifacial spasm. Diagnosis of methemoglobinemia and hemolytic anemia was made clinically and confirmed on laboratory tests. She recovered with supportive treatment and packed cell transfusion. Her previously unrecognised underlying con dition of glucose-6-phosphate dehydrogenase (G6PD) deficiency was confirmed months after the initial presentation.
This study aimed to identify potential predictors of the effectiveness of endobiliary stent placement in MBO.
Cholestatic jaundice affects up to 1 in 2500 newborns. Possible causes include bacterial sepsis, galactosemia, tyrosinemia, panhypo-pituitarism, bile acid synthetic defects, obstructive gallstones and Biliary atresia (BA). BA is a destructive cholangiopathy of neonates, which can lead to portal hypertension and liver failure if not identified early and a Kasai hepatoportoenterostomy performed timely to restore bile flow. Diagnostic algorithms vary substantially between different centres, with some units advocating ERCP be performed in every case.
Biliary stenting remains the standard of care for palliative treatment of malignant biliary strictures due to their ability to alleviate common cancer symptoms such as obstructive jaundice, malaise and discomfort. However, due to advancements in chemotherapy, patients who receive palliative stents are more frequently outliving their stents due to tissue in-growth or sludge formation within stents. This can result in a need for reintervention, interruption of treatment, and further hospitalization.
Development of walled off necrosis (WON) following an episode of necrotizing pancreatitis can result in infection, abdominal pain, intolerance of oral intake, or obstructive jaundice and can be associated with significant morbidity. Despite the fact that endoscopic intervention has emerged as first line-therapy for symptomatic WON, there are no devices specifically intended/approved in the United States for endoscopic necrosectomy. Often, multiple debridement procedures are required resulting in equipment waste, increased cost, and additive risk of adverse events.
ERCP has been the gold standard in management of patients with obstructive jaundice. However, 3 –5% of cases cannot be managed by ERCP due to various impediments, such as ampullary infiltration, altered anatomy , duodenal obstruction or to the tightness of luminal occlusion.
Endoscopic retrograde cholangiography (ERCP) is the procedure of choice for biliary decompression in patients with obstructive jaundice. In cases of failed procedure, percutaneous biliary drainage (PBD) is currently the mainstream of alternative care. On the other hand, EUS-guided rendezvous (EUS-RV) drainage is gaining popularity of reported high technical success. Current literature mostly focuses on EUS-guided transluminal drainage, while only few studied on the role of EUS-RV. We aimed to compare the success rate, efficacy and safety of EUS-RV drainage over standard care as the rescue therapy.