Journal of

Case Reports and Images in Medicine

 
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Case Report
 
Management of obstructive jaundice in stage IV cholangiocarcinoma with peritoneal carcinomatosis and history of gastrointestinal stromal tumor
Samuel B. Reynolds1, Alexander C. Podlaski1, Areeb Zamir2
1Medical Student, Department of Education, Lehigh Valley Health Network, Allentown, PA, USA.
2MD, PGME Internal Medicine, Lehigh Valley Health Network, Allentown, PA, USA.

Article ID: 100030Z09SR2017
doi:10.5348/Z09-2017-30-CR-2

Address correspondence to:
Samuel Benjamin Reynolds
3711 Allen Street
Apt 4, Allentown
PA
USA-18104

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How to cite this article:
Reynolds SB, Podlaski AC, Zamir A. Management of obstructive jaundice in stage IV cholangiocarcinoma with peritoneal carcinomatosis and history of gastrointestinal stromal tumor. J Case Rep Images Med 2017;3:4–8.


Abstract
Introduction: Biliary obstruction can cause a state of hyperbilirubinemia in patients, which is characterized by a total bilirubin level of >1.0 mg/dL. Possible causes of obstructive jaundice include biliary stone impaction, presence of tumor, and parasitic infection among others. When initial diagnosis is not known, a multidepartment treatment approach can be initiated.
Case Report: A 73-year-old female presented with obstructive jaundice and history of gastrointestinal stromal tumor (GIST) who required biliary drainage using an external/internal catheter as well as endoscopic stenting through the ampulla of Vater and common bile duct. A diagnosis of cholangiocarcinoma with metastases, rather than recurrence of GIST, was ultimately made following analysis of a biopsy taken from the diaphragm.
Conclusion: Combined radiologic intervention with percutaneous intrabiliary stenting as well as endoscopic stenting through the gastrointestinal tract and subsequent intestinal drainage can provide adequate therapy for obstructive jaundice secondary to an infiltrative mass by preventing further increase of total bilirubin and decreasing total bilirubin level through biliary drainage. Patients with additional cancer history, such as those with GIST, should undergo further evaluation to determine whether their obstructive mass is a new primary tumor or recurrent disease.

Keywords: Cholangiocarcinoma, Cholangiogram, Esophagogastroduodenoscopy, Hyperbilirubinemia


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Author Contributions
Samuel B. Reynolds – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alexander C. Podlaski – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Areeb Zamir – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Samuel B. Reynolds et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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