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Endosc Int Open 2015; 03(03): E223-E225
DOI: 10.1055/s-0034-1391670
Case report
© Georg Thieme Verlag KG Stuttgart · New York

Biliary cast syndrome in portal hypertensive biliopathy: direct cholangioscopic findings and endoscopic therapy with metal stent

Marco Aurelio D’Assuncao
1   Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Alabama, United States
2   Gastrointestinal Endoscopy Unit, Hospital Sirio Libanes, Sao Paulo, Brazil
,
Jacobo Velázquez-Aviña
1   Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Alabama, United States
,
Leona Council
3   Department of Pathology, University of Alabama at Birmingham, Alabama, United States
,
Klaus Mönkemüller
1   Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Alabama, United States
› Author Affiliations
Further Information

Publication History

submitted 05 January 2015

accepted after revision 12 January 2015

Publication Date:
14 April 2015 (online)

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Abbreviations

CT: computed tomography
HCV: Hepatitis C virus
EHPVO: extrahepatic portal venus obstruction
ERCP: endoscopic retrograde cholangiopancreatography
HCC: hepatocellular carcinoma.

A 61-year-old man with asthma, diabetes mellitus, cirrhosis secondary to chronic hepatitis C virus (HCV) infection, and hepatocellular carcinoma (HCC), was admitted to our hospital because of progressive abdominal pain and jaundice of 7 days duration. On clinical examination, the patient had abdominal distention, tenderness in the right upper quadrant, and jaundice. His hemoglobin was 8.7 mg/dL; hematocrit, 25 %; white blood cells, 1.7 × 109/L; international normalized ratio (INR), 1.4; total bilirubin, 15 mg/dL; direct bilirubin, 7.6 mg/dL; indirect bilirubin, 7.4 mg/dL; and alkaline phosphatase, 65 IU/L. The remaining laboratory parameters were within reference ranges.

 

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