In such cases if we were not absolutely sure that the wire is in the biliary system
we initially passed just the thinner stiffener of the sheath to do a cholangiogram rather than introducing the larger sheath directly.
Damage to the liver cells or to the biliary system
can affect bilirubin levels.
The developmental variations of intrahepatic and extrahepatic bile ducts in the biliary system
are observed in 42%-58% of the population (2,3).
The biliary system
is a major route of detoxification and bile acids can be used as therapeutic agents.
The involvement of the biliary system
in parasitic infections may cause severe morbidity and, rarely, mortality due directly to the parasites or to related complications, even in childhood (1, 2).
Given our and others' studies anaerobes are rare in the human biliary system
; therefore, if antibiotic therapy is considered, aerobic coverage should be satisfactory.
Reported cases of primary Langerhans cell histiocytosis of the biliary system
Case Age Sex Clinical presentation Clinical Focality of (years) association the mass 1 2.5 Female Obstructive jaundice, Primary Solitary (10) hepatosplenomegaly, sclerosing ascites, pruritus cholangitis Our 62 Female Obstructive jaundice, Primary Solitary case nausea and vomiting, sclerosing dark urine, weight cholangitis loss Case Positive Treatment Recurrences Follow-up immunochemistry /metastasis (months) markers 1 CD1a, S100 Liver None Alive, 2 (10) transplantation years Our CD1a, S100, CD68 Common bile duct None Died of case resection+cladribine sepsis, 14 months
(2) Endoscopic retrograde cholangiography is very useful as the initial procedure to confirm the diagnosis and also for treatment planning as it can accurately delineate the extent of the damage to the biliary system
. It also has the potential for being therapeutic.
MRI/MRCP may be of value in assessing proximity to the intrahepatic biliary system
and possible biliary communication of cysts, which would make BMCNs unlikely.
 In our case, any gross tumoral formation was not detected in the pancreas and biliary system
. Therefore, our patient did not have typical symptoms or signs of pancreatic tumors such as abdominal pain or obstructive jaundice.
They cover head and neck; breast and neurovascular system of the upper extremity; thorax; abdominal wall; small and large intestines; stomach, duodenum, and esophagus; liver, biliary system
, pancreas, and spleen; kidney, adrenal, ureters, and bladder; pelvis; and aorta, iliac arteries, and blood supply to the lower extremity (vascular exposure).