All of the following are true about Asiatic cholangitis except –
Correct Answer: Does not cause jaundice
Description: Ans. is 'd' i.e., Does not cause jaundice o Oriental cholangiohepatitis (or recurrent pyogenic cholangiohepatitis) is a condition essentially found in Southeast Asia and is characterised by intra- and extrahepatic bile duct strictures and dilatation with intraductal pigmented stone formation. Diagnosis is made after exclusion of more common conditions such as biliary stricture of known cause like previous surgery, trauma etc, primary or secondary sclerosing cholangitis or cholangicarcinomaClinical presentationo The common clinical presentation is that of recurrent RUQ pain, fever and jaundice. Leukocytosis with elevated alkaline phosphatase and bilirubin are seen.Pathologyo The exact aetiology is not well understood but strongly association with hepatobiliary infestation with Clonorchis sinensis (liver fluke) or ascaris lumbricoides have been implicated. Other associations include poor nutritional or socioeconomic status and ascending cholangitis from gut Escherichia coli florao The fluke acts like a nidus for stone formation and either directly or by causing strictures aids which to their formation.o Periductal inflammatory changes with infiltration of periportal spaces with inflammatory cells leading to periductal fibrosis and stricture which could ultimately leads into focal liver fibrosis or diffuse biliary cirrhosis.Radiographic featureso MRCP is superior to ERCP in depicting intra- and extrahepatic changes.Treatment and prognosiso Interventional radiology plays a role in percutaneous biliary drainage of affected segments, removal of pigment stones, balloon dilation of biliary strictures and repeated percutaneous procedures to clear pigment stones and mud-like biliary debris.Complicationso Biliary cirrhosiso Cholangiocarcinoma (in ~5% of cases)
Category:
Surgery
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