Presentation
We present herein a case where a benign bile duct stricture developed 16 years after an open cholecystectomy and without any prior symptoms. [ncbi.nlm.nih.gov]
Patients with bile duct injury after a laparoscopic cholecystectomy can present with the injury soon after the cholecystectomy or many weeks to months after the injury Patients who present early usually present with leakage of bile into the abdominal [hpbsurgery.com.au]
Entire Body System
- Pain
I am sure that is the source of my pain. The Donnatal I am on is a antispasmodic with phenabarbitol. My pain is getting worse instead of better. Hi, I have been where you are now. What they did to me was do several ERCP's spaced several weeks apart. [medhelp.org]
Clinical findings Jaundice, fever, chills, abdominal pain. Aetiology Prior local surgery, pancreatitis, trauma, gallstones. [medical-dictionary.thefreedictionary.com]
We present a case of a 64-year-old woman who presented with sudden onset jaundice and abdominal pain, 1 week following right hemicolectomy. Laboratory reports suggested obstructive jaundice. [ncbi.nlm.nih.gov]
- Inflammation
METHODS: Imaging and histologic finding of the bile duct were assessed for 73 patients with autoimmune pancreatitis to clarify whether IgG4-related biliary inflammation or pancreatic head swelling is associated with lower bile duct stricture. [ncbi.nlm.nih.gov]
Instead it arises from severe or prolonged inflammation of the bile duct. Inflammation usually arises from an injury, usually associated with surgery or diagnostic investigations. [healthhype.com]
The infection and inflammation that results from pancreatitis can affect the nearby bile duct and damage it. [liverandpancreassurgeon.com]
MEDICAL THERAPY Patients who have inflammation or infection (cholangitis) within a bile duct are treated first with antibiotics. [virginiamason.org]
- Chills
Clinical findings Jaundice, fever, chills, abdominal pain. Aetiology Prior local surgery, pancreatitis, trauma, gallstones. [medical-dictionary.thefreedictionary.com]
When this happens, bile can back up into the liver, causing abdominal pain, nausea, itching, fever, chills, and jaundice. Strictures can be caused during surgery on nearby tissues, such as the gallbladder. [emoryhealthcare.org]
Symptoms Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea and vomiting Pale or clay-colored stools Exams and Tests The following tests can help diagnose this condition: Endoscopic retrograde cholangiopancreatography [drrakeshrai.com]
[…] bile duct, liver or pancreas Damage and scarring due to a gallstone in the bile duct Damage or scarring after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills [mountsinai.org]
- Surgical Procedure
The surgical procedure associated with biliary drainage (4 choledochoduodenostomies, 1 choledochojejunostomy, and 1 biliary decompression within the pancreatic head) was a Frey procedure for five patients and a pancreaticojejunostomy for one patient. [ncbi.nlm.nih.gov]
These operations include: Cholecystectomy - A surgical procedure that removes the gallbladder. It accounts for up to 80% of all benign biliary stricture cases. Gastrectomy - A surgical procedure that removes part or the entire stomach. [docdoc.com.sg]
As all surgical procedures, bile duct stricture surgery may be associated with certain complications, which include bleeding and infection. NMC Surgery provides specialized and experienced surgeons and the best available quality treatments. [nmcsurgery.ae]
This procedure can be performed at the time of diagnosis with miniaturized surgical instruments inserted through the ERCP endoscope. [medigoo.com]
The consent was obtained routinely before the surgical procedure and not for anything specifically related to this study. Surgical procedure Roux-en-Y HJ was the standard surgical repair. [bmcgastroenterol.biomedcentral.com]
- Lymphadenopathy
EUS in addition facilitates staging by assessing regional lymphadenopathy and vascular involvement. Tissue acquisition using EUS-guided fine-needle aspiration (EUS-FNA) can also be performed (figure 2). [fg.bmj.com]
On examination, no pallor or supraclavicular lymphadenopathy. Abdominal examination was normal. Bimanual examination revealed 8 cm × 10 cm cystic mass felt through left and anterior fornix. [jmidlifehealth.org]
However, the presence of lymphadenopathy raises the possibility of diseases such as tuberculosis, lymphoma or sarcoidosis. [oapublishinglondon.com]
The findings are: Discontinuous dilatation Bile wall thickening at the level of the porta hepatis Lymphadenopathy Primary sclerosing cholangitis. late CT findings Primary sclerosing cholangitis (4) Late CT features are seen on the images on the left. [radiologyassistant.nl]
Metastatic porta lymphadenopathy may cause high-grade obstruction of the common hepatic duct. Epidemiology United States data Although quite uncommon, the exact prevalence of bile duct strictures is unknown. [emedicine.medscape.com]
Gastrointestinal
- Abdominal Pain
Clinical findings Jaundice, fever, chills, abdominal pain. Aetiology Prior local surgery, pancreatitis, trauma, gallstones. [medical-dictionary.thefreedictionary.com]
We present a case of a 64-year-old woman who presented with sudden onset jaundice and abdominal pain, 1 week following right hemicolectomy. Laboratory reports suggested obstructive jaundice. [ncbi.nlm.nih.gov]
When this happens, bile can back up into the liver, causing abdominal pain, nausea, itching, fever, chills, and jaundice. Strictures can be caused during surgery on nearby tissues, such as the gallbladder. [emoryhealthcare.org]
- Nausea
When this happens, bile can back up into the liver, causing abdominal pain, nausea, itching, fever, chills, and jaundice. Strictures can be caused during surgery on nearby tissues, such as the gallbladder. [emoryhealthcare.org]
Symptoms Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea and vomiting Pale or clay-colored stools Exams and Tests The following tests can help diagnose this condition: Endoscopic retrograde cholangiopancreatography [drrakeshrai.com]
[…] bile duct Damage or scarring after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills Fever Itching General feeling of discomfort Loss of appetite Jaundice Nausea [mountsinai.org]
Damage and scarring due to a gallstone in the bile duct Damage or scarring after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea [baptistjax.com]
- Vomiting
Symptoms Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea and vomiting Pale or clay-colored stools Exams and Tests The following tests can help diagnose this condition: Endoscopic retrograde cholangiopancreatography [drrakeshrai.com]
When to Contact a Medical Professional Call your provider if you: Cannot pass stool or gas Have a swollen abdomen (distention) that does not go away Keep vomiting Prevention Prevention depends on the cause. [mclarenhealthplan.org]
Damage or scarring after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills Fever Itching General feeling of discomfort Loss of appetite Jaundice Nausea and vomiting [mountsinai.org]
[…] scarring due to a gallstone in the bile duct Damage or scarring after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea and vomiting [baptistjax.com]
- Clay-Colored Stool
Symptoms Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea and vomiting Pale or clay-colored stools Exams and Tests The following tests can help diagnose this condition: Endoscopic retrograde cholangiopancreatography [drrakeshrai.com]
[…] after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills Fever Itching General feeling of discomfort Loss of appetite Jaundice Nausea and vomiting Pale or clay-colored [mountsinai.org]
[…] gallstone in the bile duct Damage or scarring after gallbladder removal Pancreatitis Primary sclerosing cholangitis Symptoms Symptoms include: Abdominal pain on the upper right side of belly Chills Fever Itching Jaundice Nausea and vomiting Pale or clay-colored [baptistjax.com]
Common symptoms of a bile duct stricture include: Pain in the upper-right abdomen Fever Itching Chills Nausea Jaundice (or yellow skin) Pale or clay colored stools Fatigue Weight loss Night sweats If you experience any of these symptoms, it is crucial [liverandpancreassurgeon.com]
- Dysphagia
‘A clear distinction between the dysphagia of an inflammatory stricture and that of carcinoma is impossible on clinical grounds alone.’ [en.oxforddictionaries.com]
Liver, Gall & Pancreas
- Jaundice
We present a case of a 64-year-old woman who presented with sudden onset jaundice and abdominal pain, 1 week following right hemicolectomy. Laboratory reports suggested obstructive jaundice. [ncbi.nlm.nih.gov]
- Biliary Colic
Sphincter of Oddi dysfunction or papillary stenosis: Patients usually present with biliary colic after cholecystectomy. [emedicine.medscape.com]
Sphincter of Oddi dysfunction or papillary stenosis Patients usually present with biliary colic after cholecystectomy. [ncbi.nlm.nih.gov]
- Recurrent Jaundice
The patient initially enjoyed good symptomatic relief post stenting but presented two months later with recurrent jaundice. Investigation confirmed duct dilatation and stent blockage. [ispub.com]
- Scleral Icterus
Mild jaundice and mild scleral icterus were present. Laboratory work-up revealed a total bilirubin to 2.1 mg/dL, with direct bilirubin of 1.2 mg/dL and normal liver transaminases. [acgcasereports.gi.org]
Musculoskeletal
- Back Pain
pain and upper right back pain May feel nausea and vomiting Pain can last from one to several hours. [sehatonline.wpengineers.com]
- Fracture
[…] bibliography or works cited list. stricture Oxford Dictionary of Rhymes © Oxford Dictionary of Rhymes 2007, originally published by Oxford University Press 2007. stricture • catcher, dacha, focaccia, patcher, scratcher, snatcher, stature, thatcher • facture, fracture [encyclopedia.com]
Neurologic
- Insomnia
She denied fever, chills, genitourinary symptoms, or any changes in her bowel habits but mentioned palpitations, heat intolerance, a 7-Kg unintentional weight loss, insomnia, and tremor over the preceding 6 months. [hindawi.com]
[…] flowered Argemone Satyanashi (Wild population growing near nallah; Enriched through Kantkari Extracts) in Pankaj Oudhia’s Research Documents on improvement of Promising Herbal Formulations used in Konta Forest region: Absent-mindedness with Headache and Insomnia [paramparik.blogspot.com]
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]
The cyst was followed up by sonography which was not decreasing in size so planned for further workup and surgery. Her menstrual cycles were regular with the normal flow with no dysmenorrhea. [jmidlifehealth.org]
Initial laboratory workup showed a normal CBC as well as basic blood chemistry, liver function tests, serum electrolytes, and urinalysis. Thyroid function tests revealed a TSH of <0.01 mIU/mL and a free T4 of 2.6 ng/dL. [hindawi.com]
IgG4 sclerosing disease in a 42-year-old woman who initially underwent workup for an anterior neck mass. An adrenal mass and a pancreatic mass were incidentally detected. [pubs.rsna.org]
This differentiation often poses a significant diagnostic and therapeutic challenge and extensive investigative workup may be required. [fg.bmj.com]
Colonoscopy
- Colitis
PSC is strongly associated with ulcerative colitis in up to 70% of patients, but it can also be associated with Crohn's disease of the large intestine. [radiologyassistant.nl]
Cholangiocarcinoma: This cancer arises from the biliary epithelium and is usually seen in association with choledochal cysts, PSC, chronic ulcerative colitis, and infestation by liver flukes. [emedicine.medscape.com]
[…] urine may also occur. [4] Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater. [7] Risk factors for cholangiocarcinoma include primary sclerosing cholangitis (an inflammatory disease of the bile ducts), ulcerative colitis [en.wikipedia.org]
Approximately 75% of PSC patients have associated inflammatory bowel disease, predominantly ulcerative colitis. [pubs.rsna.org]
- Polyps
During the ERCP, biopsies of the ampullary polyp were obtained together with brushings of the distal CBD stricture, and a biliary plastic stent was placed. [cytojournal.com]
Treatment
BACKGROUND/AIMS: Endoscopic treatment for postoperative benign bile duct stricture (BBS) is a therapeutic challenge. No previous studies have compared endoscopic treatments for BBS and malignant bile duct stricture (MBS). [ncbi.nlm.nih.gov]
Prognosis
AIM: To compare the outcome of endoscopic therapy for postoperative benign bile duct stricture and benign bile duct stricture due to chronic pancreatitis, including long-term prognosis. [ncbi.nlm.nih.gov]
Associated findings Associated findings are for example: features of chronic pancreatitis evidence of previous cholecystectomy lymph node enlargement infiltrating mass Treatment and prognosis Treatment and prognosis clearly depend on the underlying etiology [radiopaedia.org]
Outlook (Prognosis) Treatment is successful most of the time. Long-term success depends on the cause of the stricture. Possible Complications Inflammation and narrowing of the biliary duct may return in some people. [mountsinai.org]
Etiology
Etiology There are numerous causes of biliary duct strictures, including 1,2 : malignant cholangiocarcinoma involvement by pancreatic head adenocarcinoma involvement by ampulla of Vater adenocarcinoma involvement by gallbladder carcinoma 4 benign iatrogenic [radiopaedia.org]
Hilar bile duct stricture should be treated surgically according to various etiological features and technical principles of biliary repair. [ncbi.nlm.nih.gov]
Management Endoscopic surgery with insertion of self-expanding metal mesh stents. bile duct stricture Biliary stricture Surgery An abnormal narrowing of the common bile duct, due to local scarring, which may cause biliary obstruction Etiology Prior local [medical-dictionary.thefreedictionary.com]
The most challenging biliary strictures are the indeterminate strictures, which are defined as biliary strictures with unknown etiology following cross-sectional imaging and tissue sampling. [acgcasereports.gi.org]
The main etiology of bile duct strictures closely related to the liver is a malignancy (cancer). However, the differentiation of benign and malignant strictures is notoriously difficult. [sciencedaily.com]
Epidemiology
Gastroenterology and Hepatology (34) Surgery, Traumatology and Orthopaedics (32) Infectology (31) Anatomy (26) Histology, Embryology (24) Microbiology (23) Pharmacology (19) Emergency Medicine (17) Respiratory Medicine (17) Immunology, Allergology (16) Epidemiology [portal.mefanet.cz]
The report, which utilized the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute, also determined that the risk of aggressive thyroid cancer in patients with malignant struma ovarii is high. [emedicine.medscape.com]
Epidemiology Frequency United StatesAlthough quite uncommon, the exact prevalence of bile duct strictures (biliary strictures) is unknown. [thehealthscience.com]
[…] malignant thyroid tissue Most common thyroid malignancy to occur in struma ovarii is papillary thyroid carcinoma, followed by follicular carcinoma ICD coding ICD-10: D27.9 - benign neoplasm of unspecified ovary ICD-10: C56 - malignant neoplasm of ovary Epidemiology [pathologyoutlines.com]
Food-borne trematodiases in Southeast Asia epidemiology, pathology, clinical manifestation and control. Advances in Parasitology. 72. pp. 305–50. doi : 10.1016/S0065-308X(10)72011-X. ISBN 9780123815132. [en.wikipedia.org]
Pathophysiology
Internal Medicine (55) Medical Chemistry and Biochemistry (54) Pathology and Forensic Medicine (54) Physiology and Pathophysiology (49) Paediatrics, Neonatology (46) Gastroenterology and Hepatology (34) Surgery, Traumatology and Orthopaedics (32) Infectology [portal.mefanet.cz]
Pathophysiology Strictures of the bile duct can be benign or malignant. Benign strictures develop when the bile ducts are injured in some way. [thehealthscience.com]
[…] coding ICD-10: D27.9 - benign neoplasm of unspecified ovary ICD-10: C56 - malignant neoplasm of ovary Epidemiology Most common type of monodermal teratoma Accounts for 3% of ovarian teratomas (Pathol 2007;39:139) Usually presents in the fifth decade Pathophysiology [pathologyoutlines.com]
Pathophysiology Benign strictures develop due to damage to the bile ducts during surgery or trauma to the abdomen; a recurring condition, such as pancreatitis or bile duct stones; or a chronic disease, such as primary sclerosing cholangitis (PSC). [ncbi.nlm.nih.gov]
Prevention
Direct biliary-enteric anastomosis is the procedure of choice when possible to relieve symptoms and prevent the potentially life-threatening complications of cholangitis and septicemia. [ncbi.nlm.nih.gov]
Doherty Lippincott Williams & Wilkins, 2006 - 826 من الصفحات This volume offers authoritative, evidence-based recommendations for preventing and managing complications in all current general surgery procedures. [books.google.com]
When to Contact a Medical Professional Call your provider if you: Cannot pass stool or gas Have a swollen abdomen (distention) that does not go away Keep vomiting Prevention Prevention depends on the cause. [mclarenhealthplan.org]