Electron microscopic assessment of bile regurgitation of humans in extrahepatic obstructive jaundice

Thirty-seven patients were studied on the anatomic routes of bile regurgitation into the blood stream by electron microscopy. The aim was to identify the relationship between the clinical results and pathway of bile regurgitation. These patients were classified into 3 groups; recovered, delayed, and fatal. Transcellular, paracellular, direct communication, necrotic hepatocyte and ruptured ductule pathway were found. In the recovered group, the transcellular pathway was most frequent with an incidence of 54.17%, and a direct communication pathway was found to be 54.55% in the fatal group with a significant difference between that of the recovered and delayed group. Long-duration bile duct obstruction creates bile regurgitation by way of direct communication between the canaliculi and Disse's space, and usually with a poor prognosis, since the serum bilirubin reached the high level of 22.65 mg%. Therefore, it is better to relieve the intrabiliary pressure as early as possible to prevent the jaundice from producing the irreversible change of hepatic canaliculi and Disse's space.

Ultrasound survey of hepatobiliary lesions in Kaohsiung, Taiwan

An ultrasound survey of the liver and biliary system was made in the city of Kaohsiung and a neighbouring village in the southwest of Taiwan. 1,166 persons (538 males and 628 females between 5 and 83 years) from 388 families were examined. Abnormalities were found in 104 cases (8.9%). Hepatolithiasis was suspected in 22 cases (1.9%). This gives an incidence of hepatolithiasis of 42.3% in a total of 52 cases of cholelithiasis. Hepatoma was suspected in 4 (0.3%) of cases.