Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient
Aim: to highlight the challenges of diagnosing and treating a patient with severe intrahepatic cholangiolithiasis.Key points. Primary sclerosing cholangitis is a chronic progressive liver disease characterized by destructive inflammation and fibrosis in the bile ducts, leading to biliary strictures,...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Gastro LLC
2024-12-01
|
| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| Subjects: | |
| Online Access: | https://www.gastro-j.ru/jour/article/view/958 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860068632756224 |
|---|---|
| author | A. K. Guseva O. N. Sergeyeva T. P. Nekrasova O. T. Imaraliev A. V. Okhlobystin Y. N. Shirokova A. S. Ostrovskaya M. S. Zharkova A. S. Cherenda V. T. Ivashkin |
| author_facet | A. K. Guseva O. N. Sergeyeva T. P. Nekrasova O. T. Imaraliev A. V. Okhlobystin Y. N. Shirokova A. S. Ostrovskaya M. S. Zharkova A. S. Cherenda V. T. Ivashkin |
| author_sort | A. K. Guseva |
| collection | DOAJ |
| description | Aim: to highlight the challenges of diagnosing and treating a patient with severe intrahepatic cholangiolithiasis.Key points. Primary sclerosing cholangitis is a chronic progressive liver disease characterized by destructive inflammation and fibrosis in the bile ducts, leading to biliary strictures, secondary biliary cirrhosis, portal hypertension and liver failure. Cholangiolithiasis occurs in more than half of cases of primary sclerosing cholangitis and can be both a complication and a cause of secondary sclerosing cholangitis, maintaining inflammation in the ducts and facilitating stone formation. Genetic mutations are known to contribute to the development of gallstones in young patients, including low phospholipid-associated cholelithiasis. Despite the wide range of modern methods of radiological and endoscopic diagnostics, there are still difficulties in differential diagnostics of bile duct diseases. This article presents a clinical case of a 39-year-old male patient with primary sclerosing cholangitis, dyslipidemia and multiple cholangioliths in the gallbladder, intraand extrahepatic bile ducts.Conclusion. The presented clinical case demonstrates the difficulties in assessing pathogenesis, choosing diagnostic and therapeutic approaches in patients with severe intrahepatic lithiasis that may mimic hepatic neoplasm. Combination of non-invasive and endoscopic methods, such as magnetic resonance imaging, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and cholangioscopy, appears to be the most effective both diagnostically and therapeutically. |
| format | Article |
| id | doaj-art-a9414198ff3c495f8509af80a1eccc6d |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2024-12-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-a9414198ff3c495f8509af80a1eccc6d2025-02-10T16:14:40ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732024-12-0134510211010.22416/1382-4376-2024-34-5-102-1101084Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old PatientA. K. Guseva0O. N. Sergeyeva1T. P. Nekrasova2O. T. Imaraliev3A. V. Okhlobystin4Y. N. Shirokova5A. S. Ostrovskaya6M. S. Zharkova7A. S. Cherenda8V. T. Ivashkin9I.M. Sechenov First Moscow State Medical University (Sechenov University)N.N. Blokhin National Medical Research Center of OncologyI.M. Sechenov First Moscow State Medical University (Sechenov University)N.N. Blokhin National Medical Research Center of OncologyI.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)Aim: to highlight the challenges of diagnosing and treating a patient with severe intrahepatic cholangiolithiasis.Key points. Primary sclerosing cholangitis is a chronic progressive liver disease characterized by destructive inflammation and fibrosis in the bile ducts, leading to biliary strictures, secondary biliary cirrhosis, portal hypertension and liver failure. Cholangiolithiasis occurs in more than half of cases of primary sclerosing cholangitis and can be both a complication and a cause of secondary sclerosing cholangitis, maintaining inflammation in the ducts and facilitating stone formation. Genetic mutations are known to contribute to the development of gallstones in young patients, including low phospholipid-associated cholelithiasis. Despite the wide range of modern methods of radiological and endoscopic diagnostics, there are still difficulties in differential diagnostics of bile duct diseases. This article presents a clinical case of a 39-year-old male patient with primary sclerosing cholangitis, dyslipidemia and multiple cholangioliths in the gallbladder, intraand extrahepatic bile ducts.Conclusion. The presented clinical case demonstrates the difficulties in assessing pathogenesis, choosing diagnostic and therapeutic approaches in patients with severe intrahepatic lithiasis that may mimic hepatic neoplasm. Combination of non-invasive and endoscopic methods, such as magnetic resonance imaging, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and cholangioscopy, appears to be the most effective both diagnostically and therapeutically.https://www.gastro-j.ru/jour/article/view/958primary sclerosing cholangitischolelithiasischolangitis |
| spellingShingle | A. K. Guseva O. N. Sergeyeva T. P. Nekrasova O. T. Imaraliev A. V. Okhlobystin Y. N. Shirokova A. S. Ostrovskaya M. S. Zharkova A. S. Cherenda V. T. Ivashkin Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient Российский журнал гастроэнтерологии, гепатологии, колопроктологии primary sclerosing cholangitis cholelithiasis cholangitis |
| title | Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient |
| title_full | Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient |
| title_fullStr | Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient |
| title_full_unstemmed | Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient |
| title_short | Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient |
| title_sort | challenges in diagnosing intrahepatic cholangiolithiasis in a 39 year old patient |
| topic | primary sclerosing cholangitis cholelithiasis cholangitis |
| url | https://www.gastro-j.ru/jour/article/view/958 |
| work_keys_str_mv | AT akguseva challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT onsergeyeva challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT tpnekrasova challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT otimaraliev challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT avokhlobystin challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT ynshirokova challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT asostrovskaya challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT mszharkova challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT ascherenda challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient AT vtivashkin challengesindiagnosingintrahepaticcholangiolithiasisina39yearoldpatient |