Caroli Disease

caroli 病
  • 文章类型: Case Reports
    Caroli病也被称为先天性肝内胆管扩张症,以前称为先天性肝内胆管囊肿;它的特征是单个或多个肝内囊性扩张。在这篇文章中,我们报告了1例Caroli病(CT大小21.2×16.9×19.8cm)。术前腹部超声和增强CT误诊为胆管囊腺瘤或肝包虫病,最后通过术后组织病理学检查确诊为Caroli病。大多数疾病是单发或多发的小胆管囊性扩张。巨大的Caroli病,直径>20厘米的囊性扩张在临床上很少见。缺乏诊断巨大囊性扩张的经验,难以做出准确的诊断。因此,通过本病例报告分析影像学误诊的原因,结合相关影像学诊断经验,总结该病的影像学诊断技巧。本研究旨在加深影像学医师对巨大Caroli病的认识,减少今后对该病的误诊。
    Caroli\'s disease is also known as Congenital intrahepatic bile duct dilatation, and previously known as a congenital intrahepatic bile duct cyst; it is characterized by single or multiple intrahepatic cystic dilatations. In this article, we report a case of Caroli\'s disease (CT size 21.2 × 16.9 × 19.8 cm). Preoperative abdominal ultrasound and enhanced CT were misdiagnosed as biliary cystadenoma or hepatic echinococcosis, and finally diagnosed as Caroli\'s disease by postoperative histopathological examinations. Most of the disease is single or multiple cystic dilatation of small bile duct. Giant Caroli disease, cystic dilations with diameter >20 cm is very rarely seen in the clinic. The lack of experience of diagnosing giant cystic dilatation makes it difficult to make accurate diagnosis. Therefore, we analyze the causes of imaging misdiagnosis through this case report, and summarize the imaging diagnostic skills of the disease combined with relevant imaging diagnosis experience. The purpose of this study is to deepen the understanding of giant Caroli disease among imaging doctors so as to reduce the misdiagnosis of the disease in the future.
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  • 文章类型: Case Reports
    Caroli综合征是一种先天性疾病,主要表现为肝内胆管扩张和先天性肝纤维化。这是临床工作中的罕见情况。通常,这种疾病的诊断是通过医学影像学证实的。这里,我们报告了一例反复上消化道出血的非典型Caroli综合征。患者接受影像学检查,肝活检和全外显子组测序。影像学检查结果无特异性。然而,在病理检查的帮助下,患者被诊断为Caroli综合征。总之,对于Caroli综合征的影像学表现不确定的病例,准确的诊断应该依靠病理学。通过讨论这个具体案例,我们的目标是增强读者对这种疾病的理解,提供有价值的信息,可以帮助早期发现和适当管理的卡罗利综合征,最终改善患者预后。
    Caroli\'s syndrome is a congenital disease characterized by dilation of intrahepatic bile ducts and congenital hepatic fibrosis. It is a rare condition in clinical work. Typically, the diagnosis of this disease is confirmed through medical imaging. Here, we report a case of atypical Caroli\'s syndrome in a patient who presented with recurrent upper gastrointestinal tract bleeding. The patient underwent imaging examinations, liver biopsy and whole exome sequencing. The results of the imaging examination were non-specific. However, with the aid of pathological examination, the patient was diagnosed with Caroli\'s syndrome. In conclusion, for cases where the imaging presentation of Caroli\'s syndrome is inconclusive, an accurate diagnosis should rely on pathology. By discussing this specific case, our aim is to enhance readers\' understanding of this disease, provide valuable information that can aid in the early detection and appropriate management of Caroli\'s syndrome, ultimately improving patient outcomes.
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  • 文章类型: Case Reports
    背景技术如果年轻患者出现发烧,腹痛,黄疸和明显的影像学异常,尤其是胆道系统的扩张,它通常是由于石头或狭窄的阻碍。然而,在非常罕见的情况下,这可能是由于先天性胆道系统囊性扩张的并发症,被称为Caroli病.我们介绍了这样的患者,并讨论了鉴别诊断和对长期管理的影响。个案报告一名14岁男童因高烧及腹痛突然发作2周,前往急诊科就诊,伴随着血液的呕吐。患者无相关病史。他营养不良,脸色苍白,黄疸,右上腹疼痛。影像学显示肝内导管囊性扩张和中央点征象。没有其他特征表明晚期肝病,肾脏没有肿瘤或囊肿.做出了Caroli病的诊断。症状归因于急性胆管炎,并用抗生素改善。一周后他出院回家。没有观察到进一步的失血。结论本案例研究描述了一名上行性胆管炎患者,Caroli病的并发症.当儿童或年轻人表现出胆管炎的特征时,应在鉴别诊断中考虑该诊断。胆道成像异常,和/或上消化道出血,或者门静脉高压症。以前没有遇到过这种疾病的病例,记录在案,或在肯尼亚出版。这种情况可以提高初级保健临床医生的认识,包括儿科医生.
    BACKGROUND If a young patient presents with fever, abdominal pain, jaundice and significant imaging abnormalities, especially dilation of the biliary system, it is usually due to obstruction from stones or strictures. However, on very rare occasions, it can be due to complications of congenital cystic dilatation of the biliary system, known as Caroli disease. We present such a patient and discuss the differential diagnosis and implications for long-term management. CASE REPORT A 14-year-old boy presented to the Emergency Department with a sudden onset of high-grade fever and abdominal pain for 2 weeks, accompanied by vomiting of blood. The patient had no relevant medical history. He was malnourished and had moderate pallor, jaundice, and right upper quadrant pain. Imaging revealed cystic dilatation of intrahepatic ducts and a central dot sign. There were no features suggesting advanced liver disease otherwise, and no tumors or cysts in the kidneys. A diagnosis of Caroli disease was made. The symptoms were ascribed to acute cholangitis and improved with antibiotics. He was discharged home 1 week later. No further blood loss was observed. CONCLUSIONS This case study describes a patient with ascending cholangitis, a complication of Caroli disease. This diagnosis should be considered in the differential diagnosis when a child or young adult presents with features of cholangitis, abnormal biliary imaging, and/or upper gastrointestinal bleeding, or portal hypertension. No prior cases of this disease have been encountered, documented, or published in Kenya. This case can increase awareness among primary care clinicians, including pediatricians.
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  • 文章类型: Case Reports
    Caroli病是一种罕见的先天性畸形,易导致肝内胆管的节段性囊性扩张。Banti综合征的特征是由于慢性充血引起的持续性脾肿大,导致血细胞比容低,最终导致全血细胞减少症。在这份报告中,我们描述了一名29岁的女性,其乙型肝炎表面抗原阳性病史>20年,复发性疲劳和不适病史>1年。在检查中,患者腹胀伴明显脾肿大(肋骨下7cm),腹水伴腹部肌肉触诊压痛。全血细胞计数显示白细胞计数低,红细胞计数,和血红蛋白浓度。在治疗过程中,患者出现了多种全血细胞减少和合并脾肿大的症状,全脾切除术后她出院,恢复良好。Banti综合征和Caroli病的组合导致严重的门静脉高压症状。
    Caroli disease is a rare congenital malformation that predisposes to segmental cystic dilatation of the intrahepatic bile ducts. Banti syndrome is characterized by persistent splenomegaly due to chronic congestion, resulting in a low hematocrit and ultimately leading to pancytopenia. In this report, we describe a 29-year-old woman who presented with a >20-year history of hepatitis B surface antigen positivity and a >1-year history of recurrent fatigue and malaise. On examination, the patient had abdominal distension with marked splenomegaly (7 cm below the ribs) and ascites with tenderness of the abdominal muscles to palpation. A complete blood count showed a low white blood cell count, red blood cell count, and hemoglobin concentration. During the course of treatment, the patient developed multiple symptoms of pancytopenia and concomitant splenomegaly, and she was discharged after total splenectomy with good recovery. The combination of Banti syndrome and Caroli disease results in severe symptoms of portal hypertension.
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  • 文章类型: Case Reports
    背景:Caroli病是一种罕见的先天性疾病,以肝内胆管扩张为特征,由PKHD1基因突变引起。Caroli综合征,以肝内胆管扩张伴先天性肝纤维化为特征,与常染色体隐性遗传性多囊肾病有关.Caroli病的临床表现不典型,Caroli病容易漏诊和误诊。因此,我们报道了这个病例,希望提高临床医生对这种疾病的认识。
    方法:1例10岁女童临床表现为皮下出血。
    方法:磁共振成像(MRI)表明患者可能患有Caroli病,肝硬化,脾肿大,门静脉高压症,食管胃底静脉曲张,或海绵肾。
    方法:建议患者进行肝移植。
    结果:患者父母没有接受我们的治疗建议,他们要求去更好的医院接受进一步的治疗,所以我们没有给病人任何治疗。
    结论:这个案例提醒我们,如果我们在诊所遇到血友病患者,我们不仅应该考虑血液病和肝硬化,还要进行上腹部MRI和磁共振胰胆管造影术以排除Caroli病。
    BACKGROUND: The disease of Caroli is a rare congenital disorder, characterized by the dilated intrahepatic bile ducts, resulting from mutations in the PKHD1 gene. Caroli syndrome, characterized by dilated intrahepatic bile ducts with congenital hepatic fibrosis, is linked to autosomal recessive polycystic kidney disease. The clinical manifestations of Caroli disease are not typical, and Caroli disease is easy to be missed and misdiagnosed. Therefore, we reported this case in the hope of raising awareness of the disease among clinicians.
    METHODS: The clinical manifestation of a 10-year-old girl was subcutaneous hemorrhage.
    METHODS: Magnetic resonance imaging (MRI ) indicates that the person may have Caroli disease, cirrhosis, splenomegaly, portal hypertension, esophagogastric fundal varices, or sponge kidneys.
    METHODS: The patient was advised for liver transplantation.
    RESULTS: The patient parents did not take our treatment advice, and they asked to go to a better hospital for further treatment, so we did not give the patient any treatment.
    CONCLUSIONS: This case serves as a reminder that if we encounter a patient with hemophilia in our clinic, we should not only consider hematologic diseases and cirrhosis, but also perform an epigastric MRI and magnetic resonance cholangiopancreatography to rule out Caroli disease.
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  • 文章类型: Journal Article
    常染色体隐性遗传性多囊肾病(ARPKD)是多囊肾病的罕见且通常是早发性形式,具有典型的囊性肾脏增大和肝脏受累先天性肝纤维化或Caroli综合征的临床表现。ARPKD仍然是儿科的临床挑战,经常需要连续和长期的多学科治疗。在这次审查中,我们的目的是概述ARPKD的临床方面以及我们对疾病进展的理解的最新进展,风险模式,ARPKD的治疗。
    Autosomal recessive polycystic kidney disease (ARPKD) is the rare and usually early-onset form of polycystic kidney disease with a typical clinical presentation of enlarged cystic kidneys and liver involvement with congenital hepatic fibrosis or Caroli syndrome. ARPKD remains a clinical challenge in pediatrics, frequently requiring continuous and long-term multidisciplinary treatment. In this review, we aim to give an overview over clinical aspects of ARPKD and recent developments in our understanding of disease progression, risk patterns, and treatment of ARPKD.
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  • 文章类型: Case Reports
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  • 文章类型: English Abstract
    A patient with Caroli disease is described. The authors used 3D modeling and 3D printing when choosing surgical strategy. Advisability of 1.5% meglumine sodium succinate 500 ml IV once a day (courses for 5 and 8 days) is justified. Thanks to antihypoxic mechanism, this drug reduced intoxication syndrome and length of hospital-stay, as well as improved quality of life.
    Описано клиническое наблюдение болезни Кароли. Приведен пример использования 3D-моделирования и 3D-печати при выборе хирургической тактики. Обосновано включение в схему терапии сопровождения 1,5% раствора меглюмина натрия сукцината (внутривенно капельно 1 раз в день 500 мл, курсы 5 и 8 дней), который благодаря своему антигипоксическому механизму действия способствовал уменьшению интоксикационного синдрома и, как следствие, сокращению сроков госпитализации и повышению качества жизни пациентки.
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  • 文章类型: Case Reports
    背景:Caroli病是连接到主管的大型肝内胆管的多灶性节段扩张。它被认为是一种罕见的疾病,发病率为1,000,000个婴儿中的1个。Caroli有两种类型:第一种类型是简单类型,Caroli病,其中仅包括肝内胆管的囊性扩张。第二种叫做Caroli综合征,由Caroli病和先天性肝纤维化组成,可能导致门静脉高压,导致食管静脉曲张和脾肿大。房间隔缺损是最常见的先天性心脏病之一。当左右心房之间的连接无法关闭时发生。多指畸形是手脚最常见的先天性畸形之一。它表现为手或脚趾上多余的手指。
    方法:一名6岁的阿拉伯女孩因腹部肿大而上月因腹痛入院。患者出生时已被诊断出患有Caroli病和多指(每条肢体上有六个手指)。包括全血细胞计数在内的调查,血涂片,骨髓活检,食管镜检查,腹部超声,计算机断层扫描显示脾肿大与脾功能亢进有关,四级非出血静脉曲张,左叶和右叶的肝内囊性形成,和左向右分流的房间隔缺损。在患者接种适当的疫苗后,她计划进行脾切除术。在医院随访一周后,全血细胞计数有改善.一个月后,患者有肝脓肿和胆瘘,经适当治疗,症状得到缓解.
    结论:肝脏疾病的关联,多指,先天性心脏病极为罕见,文献中只记载了几次。然而,根据我们的知识,房间隔缺损以前从未参与过这种组合.家族史也使这种情况变得独特,并强烈暗示了遗传病因。
    BACKGROUND: Caroli disease is multifocal segmental dilatation of the large intrahepatic bile ducts that connect to the main duct. It is considered a rare disease with an incidence rate of 1 in 1,000,000 births. There are two types of Caroli: the first type is the simple type, Caroli disease, which includes only cystic dilatation of the intrahepatic bile ducts. The second is called Caroli syndrome, which consists of Caroli disease and congenital hepatic fibrosis and might lead to portal hypertension leading to esophageal varices and splenomegaly. Atrial septal defect is one of the most common congenital heart diseases, occurring when the connection between the left and the right atriums fails to close. Polydactyly is one of the most common congenital malformations of the hands and feet. It manifests in excess fingers on the hands or toes.
    METHODS: A 6-year-old Arab girl presented to the hospital with abdominal pain for the last month with abdominal enlargement. The patient was already diagnosed with Caroli disease and polydactyly (six fingers on each limb) when she was born. Investigations including complete blood count, blood smear, bone marrow biopsy, esophagoscopy, abdominal ultrasound, and computed tomography scan showed splenomegaly associated with hypersplenism, fourth-grade non-bleeding varices, intrahepatic cystic formations in the left and right lobes, and an atrial septal defect with a left-to-right shunt. The patient was scheduled for a splenectomy after she was vaccinated with the appropriate vaccines. After follow-up for a week in the hospital, complete blood count showed an improvement. A month after that, the patient had liver abscesses and biliary fistula that were treated appropriately and her symptoms resolved.
    CONCLUSIONS: The association of liver diseases, polydactyly, and congenital heart diseases is extremely rare and was only documented few times in the literature. However, to our knowledge, atrial septal defect has never been part of this combination before. The family history also makes this case unique and strongly suggests genetic etiology.
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  • 文章类型: Journal Article
    背景:胆道囊肿(BC)是原位肝移植(OLT)的罕见指征。
    方法:我们查询了UNOS数据集,以确定因Caroli病(CD)和胆总管囊肿(CC)而接受OLT的患者。将所有BC(CDCC)患者与其他适应症移植的患者队列进行比较。还将患有CC的患者与患有CD的患者进行比较。进行Cox比例风险模型以评估移植物和患者存活的预测因子。
    结果:261例患者因BC行OLT。与其他适应症移植的患者相比,BC患者的术前肝功能更好。5年移植物和患者生存率分别为72%和81%,分别,与匹配后移植的其他适应症相似。与CD患者相比,CC患者更年轻,术前胆汁淤积增加。捐赠者年龄,种族,性别和性别是CC移植患者移植物和患者存活率差的预测因素。
    结论:BC患者与其他适应症的移植结果相似,更常见的是需要MELD评分例外。在胆总管囊肿移植的患者中,女性性别,供体年龄,和非裔美国人种族是生存不佳的独立预测因素。与成人相比,因Caroli病移植的小儿患者的生存率更好。
    Biliary cysts (BC) is a rare indication for orthotopic liver transplantation (OLT).
    We queried the UNOS dataset to identify patients who underwent OLT for Caroli\'s disease (CD) and choledochal cysts (CC). All patients with BC (CD + CC) were compared to a cohort of patients transplanted for other indications. Patients with CC were also compared to those with CD. Cox proportional hazard model was performed to assess predictors of graft and patient survival.
    261 patients underwent OLT for BC. Patients with BC had better pre-operative liver function compared to those transplanted for other indications. 5-year graft and patient survival were 72% and 81%, respectively, similar to those transplanted for other indications after matching. Patients with CC were younger and had increased preoperative cholestasis compared to those with CD. Donor age, race, and gender were predictors of poor graft and patient survival in patients transplanted for CC.
    Patients with BC have similar outcomes to those transplanted for other indications and more frequently require MELD score exception. In patients transplanted for choledochal cysts, female gender, donor age, and African-American race were independent predictors of poor survival. Pediatric patients transplanted for Caroli\'s disease had better survival compared to adults.
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