Comparative evaluation of magnetic resonance cholangiopancreatography/magnetic resonance splenoportovenography and endoscopic ultrasound in the diagnosis of portal cavernoma cholangiopathy

Prakash, Gyan; Nijhawan, Sandeep; Madhu, MP; Sharma, Shyam Sundar; Pokharna, Rupesh

doi:10.1007/s12664-015-0610-3

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…In the asymptomatic stage, which has an average duration of 8-10 years, early changes can already be identified at MRCP (irregularities, parietal impressions, stenosis) with or without altered biochemical tests (minor increase in alkaline phosphatase and bilirubin levels) [14]. Biliary colic, jaundice, cholestasis and cholangitis appear late in the evolution of the disease and only in patients with advanced changes at MRCP [8]. Risk factors for the occurrence of symptomatic PCC are: prolonged duration of the disease, history of variceal hemorrhage, cholestasis, bile duct stones and advanced (grade III) cholangiographic findings (biliary strictures, dilatations) [15].…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic Challenges for Symptomatic Portal Cavernoma Cholangiopathy

Cavaşi

Mercea

Anton

et al. 2016

JGLD

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Although transjugular intrahepatic portosystemic shunts are most frequently used for the management of portal hypertension, the surgical approach is preferred for symptomatic portal cavernoma cholangiopathy. We present the case of a 25-year old female patient with a portal cavernoma secondary to catheterization of the umbilical vein at birth. She had had two episodes of esophageal variceal bleeding, successfully treated by endoscopic banding. and an episode of acute cholangitis secondary to portal cavernoma cholangiopathy. Endoscopic sphincterotomy and biliary stenting were performed, and were followed by repeated episodes of biliary stent occlusion. The last biliary drainage procedure triggered a massive hemobilia. Since endoscopic therapy was ineffective, a surgical mesocaval shunt with graft interposition and splenectomy was performed with favorable outcome. In selected cases, the mesocaval shunting plays an essential role in the treatment of portal cavernoma cholangiopathy even in the era of interventional radiology. Abbreviations: CBD: common bile duct; CT: computed tomography; ERCP: endoscopic retrograde cholangiopancreatography; IVC: inferior vena cava; LHD: left hepatic duct; MRCP: magnetic resonance cholangiopancreatography; PC: portal cavernoma; PCC: portal cavernoma cholangiopathy; SMV: superior mesenteric vein.

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Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance cholangiopancreatography (MRCP) combined with an MR portovenography depicts biliary and vascular abnormalities. Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure, reserved only for therapeutic purposes such as biliary stenting or extraction of bile duct stones [7,8].…”

Section: Introductionmentioning

confidence: 99%