The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report
Biliary strictures diagnosis has become a challenge where benign conditions could mimic a malignant process. Recently, SpyGlass DS overcame the limitations by allowing direct visualization of the biliary tree. A 65 years old Indian patient complaints of jaundice with total and direct bilirubin of 23...
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| Format: | Article |
| Language: | English |
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Interna Publishing
2022-01-01
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| Series: | Acta Medica Indonesiana |
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| Online Access: | http://www.actamedindones.org/index.php/ijim/article/view/1184 |
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| author | Muhammad Miftahussurur Manu Tandan Dadang Makmun |
| author_facet | Muhammad Miftahussurur Manu Tandan Dadang Makmun |
| author_sort | Muhammad Miftahussurur |
| collection | DOAJ |
| description | Biliary strictures diagnosis has become a challenge where benign conditions could mimic a malignant process. Recently, SpyGlass DS overcame the limitations by allowing direct visualization of the biliary tree. A 65 years old Indian patient complaints of jaundice with total and direct bilirubin of 23.3 mg/dL and 16.2 mg/dL, respectively. Liver function test, gamma-glutamyltransferase and CA 19-9 were increased. Transabdominal ultrasound and abdominal CT supported dilatation of common bile duct (CBD) with abrupt narrowing showing periductal enhancement at supra pancreatic level and stricture. Endoscopic ultrasound showed intrahepatic CBD stricture with dilated proximal CBD and sludge ball. Endoscopic retrograde cholangiopancreatography showed mid CBD stricture. Although brush cytology results suggested low grade dysplasia and no definite evidence of malignancy, cholangioscopy using SpyGlass DS found nodularity with abnormal vascularity seen in mid of CBD suggesting malignancy, confirmed with histopathology as cholangiocarcinoma. We reported additional value of SpyGlass DS for detecting cholangiocarcinoma in an indeterminate biliary stricture patient. |
| format | Article |
| id | doaj-art-55dd5f26b9234b4ebeea0369910ec5b1 |
| institution | Kabale University |
| issn | 0125-9326 2338-2732 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj-art-55dd5f26b9234b4ebeea0369910ec5b12025-08-20T03:50:00ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322022-01-01534The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case reportMuhammad Miftahussurur0Manu Tandan1Dadang Makmun2Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia. Gastroentero-Hepatology division, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu 8795593, JapanAsian Institute of Gastroenterology, Hyderabad, IndiaDivision of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaBiliary strictures diagnosis has become a challenge where benign conditions could mimic a malignant process. Recently, SpyGlass DS overcame the limitations by allowing direct visualization of the biliary tree. A 65 years old Indian patient complaints of jaundice with total and direct bilirubin of 23.3 mg/dL and 16.2 mg/dL, respectively. Liver function test, gamma-glutamyltransferase and CA 19-9 were increased. Transabdominal ultrasound and abdominal CT supported dilatation of common bile duct (CBD) with abrupt narrowing showing periductal enhancement at supra pancreatic level and stricture. Endoscopic ultrasound showed intrahepatic CBD stricture with dilated proximal CBD and sludge ball. Endoscopic retrograde cholangiopancreatography showed mid CBD stricture. Although brush cytology results suggested low grade dysplasia and no definite evidence of malignancy, cholangioscopy using SpyGlass DS found nodularity with abnormal vascularity seen in mid of CBD suggesting malignancy, confirmed with histopathology as cholangiocarcinoma. We reported additional value of SpyGlass DS for detecting cholangiocarcinoma in an indeterminate biliary stricture patient.http://www.actamedindones.org/index.php/ijim/article/view/1184Biliary stricturecancerSpyGlass DScholangiocarcinoma |
| spellingShingle | Muhammad Miftahussurur Manu Tandan Dadang Makmun The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report Acta Medica Indonesiana Biliary stricture cancer SpyGlass DS cholangiocarcinoma |
| title | The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report |
| title_full | The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report |
| title_fullStr | The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report |
| title_full_unstemmed | The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report |
| title_short | The role of SpyGlass Direct Visualization System on Patient with Indeterminate biliary strictures: A case report |
| title_sort | role of spyglass direct visualization system on patient with indeterminate biliary strictures a case report |
| topic | Biliary stricture cancer SpyGlass DS cholangiocarcinoma |
| url | http://www.actamedindones.org/index.php/ijim/article/view/1184 |
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