Authors
Dynko V.Yu. 1, Gabriel S.A.1, Mamishev A.K.1, Krushelnitsky V.S.1, Bespechnyy M.V.1, Makarenko A.S.1, Gritsay A.D.1, 2
1 Regional Clinical Hospital № 2, Krasnodar
2 SBEA HE «Kuban State Medical University», Krasnodar
Abstract
The objective was to show a clinical case of differential diagnosis of parasitic invasion of the common bile duct.
Methods: this paper presents a clinical case. The patient, 52 years old, was transferred from the CRH with the diagnosis: blockage of the bile ducts, tumor of the bile ducts, mechanical jaundice, cholestatic hepatitis, cholangitis. Based on the results of the anamnesis collection, on the basis of complaints, data from physical, laboratory and instrumental examination methods, a preliminary diagnosis was made: a tumor of the bile ducts. Retrograde cholangiopancreatography (RHPG), cannulation endoscopic papillotomy, revision of the common bile duct with a Dormia-type basket was performed, the block level was determined at the level of the upper third of the common bile duct, for which the instrument could not be performed. Retrograde cholangioscopy was performed to clarify the nature of the obstruction and morphological verification of the tumor.
Results: When performing cholangioscopy, parasites were detected in the patient’s common bile duct, which were extracted. The patient is sent for treatment to an infectious diseases hospital.
Keywords: мechanical jaundice, bile duct tumor, retrograde cholangiopancreatography, retrograde cholangioscopy.
References
1. Bagnenko SF. Optimizing of treatment strategy with cholelithiasis complicated by choledocholitiasis. Vestnik Rossiyjskoy voennomedicinskoj akademii. 2012; 3: 35-42. (In Russ.)
2. Cantù P. Post-operative biliary strictures. Dig Liver Dis. 2020; 52(12): 1421-1427.
3. Littlefield A. Cholelithiasis: Presentation and Management. J Midwifery Womens Health. 2019; 64(3): 289-297.
4. Perisetti A. Cholelithiasis in a Patient With History of Cholecystectomy. Clin Gastroenterol Hepatol. 2018; 16(6): e66-e67.
5. Zhang J. Risk factors and management of primary choledocholithiasis: a systematic review. ANZ J Surg. 2021; 91(4): 530-536.
6. Sokolina FM, Ilaltdinov R, Golikov A. Stroenie rotovoi prisoski trematodi Fasciola hepatica L., 1758. Materiali dokladov nauchnoi konferencii Vserossiiskogo obschestva gelmintologov RAN «Teoriya i praktika borbi s parazitarnimi boleznyami». 14: 377-9. (In Russ.)
7. Veigh Р, Maule А. Fasciola hepatica virulence-associated cysteine peptidases: a systems biology perspective. 2012; 14(4): 301-10. doi: 10.1016/j.micinf.2011.11.012.
8. Stürchler D. Fasciola hepatica — Convoluted life forms and names. Travel Med Infect Dis. 2018; 21: 85. doi: 10.1016/j.tmaid.2018.01.008.
9. Dar Y, Vignoles P, Dreyfuss G, Rondelaud D. Fasciola hepatica and Fasciola gigantica: comparative morphometric studies on the redial stage of both species Parasitol Res. 2003; 91(5): 369-73. doi: 10.1007/s00436-003-0966-7.
10. Wilson RA, Wright JM, de Castro-Borges W, Parker-Manuel SJ, Dowle AA, Ashton PD, Young ND, Gasser RB, Spithill TW. Exploring the Fasciola hepatica tegument proteome. Int J Parasitol. 2011; 41(13-14): 1347-59. doi: 10.1016/j.ijpara.2011.08.003.
