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Meng C, Wang J, Zhang P, Wang B. Case report: The diagnostic dilemma of indeterminate biliary strictures: report on two cases with a literature review. Front Oncol 2024; 14:1301937. [PMID: 38601754 PMCID: PMC11004331 DOI: 10.3389/fonc.2024.1301937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Background It is still a challenging problem for clinicians to explore the nature of the indeterminate biliary strictures (IBSs). Approximately 20% of biliary strictures remain undetermined after a thorough preoperative assessment. Case presentation Here, we present two cases of indeterminate biliary strictures patients, whose cross- sectional imaging and endoscopic examination were nondiagnostic. The patients underwent exploratory laparotomy finally and were confirmed as malignancy. We also reviewed the recent reports in literatures regarding the evaluation of IBSs. Conclusions Given the majority of the biliary strictures are malignancy, preoperative differentiation between benign and malignant is critical for choosing the best therapeutic regimen. Thus, close follow-up, multiple multidisciplinary discussion, and prompt surgical exploration are necessary for some difficult diagnostic cases.
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Affiliation(s)
- Chunyan Meng
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peipei Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Wang
- Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sinagra E, Mandarino FV, Rossi F, Alloro R, Testai S, Marasà M, Cristofalo S, Maida M, Brinch D, Conoscenti G, Fasulo E, Raimondo D. A Case of Foreign Body in the Biliary Tree and the Challenge of Hypereosinophilia. GASTROINTESTINAL DISORDERS 2023; 5:431-437. [DOI: 10.3390/gidisord5040035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
In all reported cases of foreign body migration or impaction in the biliary tree, there is no mention of the presence of hypereosinophilia among the laboratory findings. This could possibly be attributed to the local tissue reaction caused by the impacted foreign body. Here, we present our experience with the removal of a screw from a surgical retractor that became lodged in the common bile duct (CBD) and migrated in a patient who had previously undergone a left lateral hepatectomy for hepatic hydatidosis. The imaging was not sufficient to make a diagnosis, and the interpretation of hypereosinophilia in such a case could pose a challenge.
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Affiliation(s)
- Emanuele Sinagra
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Francesco Vito Mandarino
- Department of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Hospital, 20132 Milan, Italy
| | - Francesca Rossi
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Rita Alloro
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Sergio Testai
- Radiology Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Marta Marasà
- Radiology Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Serena Cristofalo
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
| | - Daniele Brinch
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Giuseppe Conoscenti
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Ernesto Fasulo
- Department of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Hospital, 20132 Milan, Italy
| | - Dario Raimondo
- Gastroenterology & Endoscopy Unit, Fondazione Istituto Gemelli-G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
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