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Bile Duct Disease

Disease of Bile Duct


Presentation

  • This best practice article summarizes the basis for gallbladder and bile duct pathology, describes the context and clinical presentation of biliary disease, and provides recommended approaches to delivery of high-quality care for patients with CF.[ncbi.nlm.nih.gov]
  • These tests reveal if a tumor is present and can provide very detailed images of the bile ducts and liver. Endoscopic retrograde cholangiopancreatography (ERCP).[sharonaross.com]
  • Article Extract Cholelithiasis (one or more gallstones within the gallbladder) is present in 15% of people over 50 years of age, and most patients with an incidental finding of gallstones have no symptoms.[medicinetoday.com.au]
Aspiration
  • Fine needle aspiration (FNA). If you have an area that could be a cancerous tumor, a biopsy of the tumor taken through an FNA may be done. This involves a small needle that removes small samples of several layers of cells.[sharonaross.com]
  • EUS with EUS-guided fine-needle aspiration as the first endoscopic test for the evaluation of obstructive jaundice. Gastrointest Endosc. 2001 Apr. 53(4):475-84. [Medline]. Friedman LS. The liver, biliary tract, and pancreas.[emedicine.medscape.com]
Yawning
  • By Richard Klasco, M.D Photo Credit Ask Well Photo Credit Why Do We Yawn? Reading about yawning makes people yawn. You are probably yawning right now. By Roni Caryn Rabin Latest Search Latest Articles Search Articles 13845 results for sorted by[nytimes.com]
Abdominal Pain
  • Symptoms: Abdominal pain in the upper right quadrant or the middle of the upper abdomen Nausea Vomiting Fever Jaundice Loss of appetite Signs and tests: Tests that show the location of stones in the bile duct include the following: ERCP (endoscopic retrograde[digestivedisease.uthscsa.edu]
  • When bile duct stones cause significant blockages, symptoms may include: Abdominal pain in the upper or middle-upper abdomen Jaundice (yellowing of the skin and eyes) Fever Nausea and vomiting Loss of appetite Dark urine Pale-colored stools How are bile[henryford.com]
  • Symptoms Symptoms may include: Abdominal pain in the upper right side Dark urine Fever Itching Jaundice (yellow skin color) Nausea and vomiting Pale-colored stools Exams and Tests Your health care provider will examine you and feel your belly.[mountsinai.org]
  • Blockage of the bile ducts may cause symptoms such as abdominal pain, nausea and vomiting.[patients.gi.org]
Nausea
  • Symptoms: Abdominal pain in the upper right quadrant or the middle of the upper abdomen Nausea Vomiting Fever Jaundice Loss of appetite Signs and tests: Tests that show the location of stones in the bile duct include the following: ERCP (endoscopic retrograde[digestivedisease.uthscsa.edu]
  • Symptoms of Bile Duct Disorders Disruption of bile duct function can cause a variety of symptoms, the most common of which include: Jaundice Nausea and vomiting Itchy skin Pain Diagnosis of Bile Duct Disorders The following diagnostic tests may be performed[nyp.org]
  • When bile duct stones cause significant blockages, symptoms may include: Abdominal pain in the upper or middle-upper abdomen Jaundice (yellowing of the skin and eyes) Fever Nausea and vomiting Loss of appetite Dark urine Pale-colored stools How are bile[henryford.com]
  • Symptoms Symptoms may include: Abdominal pain in the upper right side Dark urine Fever Itching Jaundice (yellow skin color) Nausea and vomiting Pale-colored stools Exams and Tests Your health care provider will examine you and feel your belly.[mountsinai.org]
  • Blockage of the bile ducts may cause symptoms such as abdominal pain, nausea and vomiting.[patients.gi.org]
Clay-Colored Stool
  • colored stool, fever, itchy skin, nausea and vomiting, and unexplained weight loss.[publichealth.va.gov]
  • Signs & Symptoms These are signs and symptoms of bile duct cancer: Yellowing of the skin or whites of the eyes, also called jaundice Dark-colored urine Clay-colored stool Pain in the abdomen Fever Itchy skin Nausea and vomiting Weight loss for an unknown[healthcare.utah.edu]
  • Fever with/without chills Nausea and/or vomiting Yellow skin – obstructive jaundice Dark urine Pale stools or clay colored stools Itchy skin – pruritis Malaise It is not uncommon for patients to report repeated episodes of biliary colic prior to the onset[healthhype.com]
  • Affected individuals may also exhibit diarrhea, excess fats in the stools (steatorrhea), and pale or clay-colored stools due to the suppression of bile flow (acholic stools).[rarediseases.org]
  • […] skin or eyes (jaundice) See your healthcare provider right away if you have any of these symptoms during or after a gallbladder attack: Pain that lasts more than 5 hours Sweating Chills Low-grade fever Yellowish color of the skin or whites of the eyes Clay-colored[cedars-sinai.edu]
Excitement
  • Prof Heinrich Wedemeyer of Hannover Medical School in Germany described PSC as "the most awful liver disease" and said he was "extremely excited" that "for the first time there is some hope for these patients." Reference Trauner M et al.[infohep.org]
  • Ogawa also sees other exciting opportunities in these advances and states that: “With our ability to make two of the major liver cell types, we are now in a position to put the pieces together and produce a piece of functional liver tissue in the Petri[sickkids.ca]
Meningism
  • MR imaging of the cranial meninges with emphasis on contrast enhancement and meningeal carcinomas. AJR 1989;153:1039–1049 PubMed Google Scholar 7. Edelman RR, Siegel JB, Singer A, Dupuis K, Longmaid HE.[link.springer.com]
Dark Urine
  • urine Diagnosis of a Bile Duct Condition If your doctor suspects you may have a bile duct blockage, tests will be done to look at the extent of the blockage and determine what is causing it.[sharonaross.com]
  • When bile duct stones cause significant blockages, symptoms may include: Abdominal pain in the upper or middle-upper abdomen Jaundice (yellowing of the skin and eyes) Fever Nausea and vomiting Loss of appetite Dark urine Pale-colored stools How are bile[henryford.com]
  • Symptoms Symptoms may include: Abdominal pain in the upper right side Dark urine Fever Itching Jaundice (yellow skin color) Nausea and vomiting Pale-colored stools Exams and Tests Your health care provider will examine you and feel your belly.[mountsinai.org]
  • If you have the tell-tale signs of liver disease—yellow skin, pale stool, dark urine, tendency to bruise—the first step to recovery is a thorough and comprehensive evaluation and diagnosis.[cpmc.org]

Workup

  • A biliary drain can also be used to take bile samples for diagnostic workup or disease monitoring, as well as providing a route of administration for medical substances.[en.wikipedia.org]

Treatment

  • Minimally invasive treatments: This year, our experienced gastroenterologists are on target to perform the most endoscopic retrograde cholangiopancreatography (ERCP) treatments in the region.[henryford.com]
  • There are currently no good treatment options other than liver transplantation.[infohep.org]
  • Treatment for a Blocked Bile Duct The goal of treatment is to physically remove the blockage. The way this is done is determined by the cause and location of the obstruction. For blockages at the sphincter of Oddi caused by gallstones.[sharonaross.com]
  • Learn more about biliary stone treatment.[nyp.org]

Prognosis

  • Cancer of the bile ducts - known as cholangiocarcinoma - is the second most common primary liver cancer and has a very poor prognosis.[eurekalert.org]
  • Outlook (Prognosis) If the blockage is not corrected, it can lead to life-threatening infection and a dangerous buildup of bilirubin. If the blockage lasts a long time, chronic liver disease can result.[mountsinai.org]
  • Prognosis As GBC is often detected only at an advanced disease stage, the prognosis is poor with 5-year survival rates of approximately 20%. The documents contained in this web site are presented for information purposes only.[orpha.net]
  • Parents should talk to their children’s physician and medical team about their specific case, associated symptoms and overall prognosis.[rarediseases.org]
  • In general a lower number in each category means a better prognosis. The stage of the cancer is used to plan the treatment.[bccancer.bc.ca]

Etiology

  • Etiology The exact etiology is unknown. Genetic susceptibility elicited by chronic inflammation of the gallbladder leading to dysplasia and malignant change is one possibility.[orpha.net]
  • The etiology is unknown, although some of these patients have biliary parasites. The disease is characterized by the presence of intrahepatic pigmented stones and recurrent infection.[radiologyassistant.nl]
  • The etiology of this disorder in patients who are HIV-positive is thought to be infectious (cytomegalovirus, Cryptosporidium species, and microsporidia have been implicated).[emedicine.medscape.com]
  • Gallstones and Cholecystitis Definition and Etiology Gallbladder stones are an extremely common disorder and are usually asymptomatic.[clevelandclinicmeded.com]

Epidemiology

  • Epidemiology of gallbladder disease: Cholelithiasis and cancer. Gut Liver. 2012;6:172-187. Definition and facts for gallstones. National Institute of Diabetes and Digestive and Kidney Diseases. Available at . Accessed 1/12/18.[crohnsdisease.com]
  • Summary Epidemiology Annual incidence rates vary from 1/100,000 to 1/ 4,350 between different ethnic groups and geographical regions.[orpha.net]
  • Epidemiology of biliary atresia: population-based study. Pediatrics . 99 (3): 376-382. doi: 10.1542/peds.99.3.376[rfs.sirweb.org]
  • Section1: Epidemiology and aetiology More than 80% of gallstones result from precipitation of cholesterol crystals within the gallbladder, which aggregate with other constituents of bile to form biliary sludge and calculi.[gponline.com]
  • Epidemiologic studies have shown variations in the prevalence of gallstones in different ethnic populations, with particularly high rates in Native Americans.[clevelandclinicmeded.com]
Sex distribution
Age distribution

Pathophysiology

  • Specifically, it is questioned whether types II, III, and V are pathophysiologically related to I and IV. Some also think the difference between I and IV may be artificial. Komi classification of bile duct cysts Promoted articles (advertising)[radiopaedia.org]
  • Pathophysiology and Natural History Most gallstones are composed primarily of cholesterol, with smaller amounts of mucus, calcium bilirubinate, and protein.[clevelandclinicmeded.com]
  • Bile Duct Obstruction Background Pathophysiology A blockage in any pathway that carries bile from the liver to the gallbladder or small intestine that can lead to a buildup of both conjugated and unconjugated bilirubin and alkaline phosphatase Bile: made[rfs.sirweb.org]
  • Gallbladder disease: Pathophysiology, diagnosis and treatment. US Pharmacist. 2013; 38(3): 33-41 Leitzmann MF, Giovannucci EL, Stampfer MJ, et al. Prospective study of alcohol consumption patterns in relation to symptomatic gallstone disease in men.[gponline.com]
  • […] in the hepatodudoenal ligament and then courses through the head of the pancreas for approximately 2 cm; it joins the terminal part of the pancreatic duct to form the ampulla of Vater before passing through the papilla of Vater into the duodenum. [1] Pathophysiology[emedicine.medscape.com]

Prevention

  • Therefore, a thorough understanding and efficient clinical evaluation of the gallbladder and biliary tree is an important aspect of integrated care for the patient with CF in order to prevent progression of undetected pathology.[ncbi.nlm.nih.gov]
  • Prevention Be aware of any risk factors you have, so that you can get prompt diagnosis and treatment if a bile duct becomes blocked. The blockage itself may not be preventable. References Fogel EL, Sherman S.[mountsinai.org]
  • Midazolam for Sedation During ERCP Completed NCT02027311 Phase 4 Etomidate;Midazolam;Meperidine 17 Preventing Cholestasis Using SMOFLipid Completed NCT01585935 Phase 4 SMOFLIPID;INTRALIPID 18 Effectiveness of S-adenosyl-L-methionine in Patients With Primary[malacards.org]
  • Strictures of the bile duct — a stricture is a narrowing of the bile duct, which prevents bile from draining into the intestine. The bile backs up into the liver, causing obstructive jaundice. Strictures of the bile duct can be benign or malignant.[froedtert.com]
  • At a press conference discussing these findings, Prof Trauner said that while PSC is a rare disease, it is a major indication for liver transplants in parts of Northern Europe – and will likely become all the more so once hepatitis B is mostly prevented[infohep.org]

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