Metastatic melanoma is renowned for its propensity to spread to almost every organ of the body; however, symptomatic metastases within the biliary tree are very rare. We report two cases of bile duct obstruction from metastatic melanoma. The first case was caused by an intraluminal metastatic melanoma to the common bile duct, while the second case was caused by extraluminal involvement. The unique aspects of these cases include clinical presentations masquerading as biliary colic, cholangitis and obstructive jaundice. Management and follow up for 3 years is presented. Aspects of medical and surgical management, as well as a review of the world's literature are discussed.
Metastatic melanoma is renowned for its propensity to spread to almost every organ of the body; however, symptomatic metastases within the biliary tree are very rare. We report two cases of bile duct obstruction from metastatic melanoma. The first case was caused by an intraluminal metastatic melanoma to the common bile duct, while the second case was caused by extraluminal involvement. The unique aspects of these cases include clinical presentations masquerading as biliary colic, cholangitis and obstructive jaundice. Management and follow up for 3 years is presented. Aspects of medical and surgical management, as well as a review of the world's literature are discussed.
A satellite endoscopy service was formally established in late January 1997 in one peripheral hospital, a second service commencing in April 1997, and a third in December 1997. More than 500 patients underwent gastrointestinal endoscopic procedures at these satellite services during 1997. The feedback received to date indicates that the establishment of this service is supported by patients and the peripheral hospitals. It is expected that this project will achieve all its stated objectives. In addition, the implementation of this service will assist in improved waiting list management at Royal Perth Hospital. The satellite endoscopy service is a unique development in Western Australia and has demonstrated definite benefits to patients in less than six months of operation.
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