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Miyamoto S, Ishii Y, Serikawa M, Tsuboi T, Tsushima K, Nakamura S, Hirano T, Ohdan H, Arihiro K, Aikata H. [A case of Caroli's disease associated with intrahepatic cholangiocarcinoma]. Nihon Shokakibyo Gakkai Zasshi 2022; 119:674-682. [PMID: 35811125 DOI: 10.11405/nisshoshi.119.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 65-year-old male with Caroli's disease had a fast rise in serum CA19-9 level during follow-up. Contrast-enhanced computed tomography (CT) revealed an irregular mass with a 3cm diameter, showing ring-like and delayed improvement in segment 8 of the liver. Gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid-enhanced magnetic resonance imaging (MRI) demonstrated a mass with the hypointense signal on T1-weighted images, mildly hyperintense signal on T2-weighted images, and hypointense signal in the hepatobiliary phase. Positron emission tomography/CT revealed the absorption of (18) F-fluorodeoxyglucose in the hepatic mass and a nodule in the anterior mediastinum. The patient was diagnosed with intrahepatic cholangiocarcinoma and supraclavicular lymph node metastasis and had partial hepatectomy and lymph node dissection. Caroli's disease is an uncommon congenital condition with myriad small cystic dilatations of the peripheral intrahepatic bile duct as the primary lesion. The disease is not only often associated with recurrent cholangitis and hepatolithiasis but is also a high-risk group of intrahepatic cholangiocarcinoma. Caroli's disease requires regular screening for intrahepatic cholangiocarcinoma utilizing suitable imaging modalities, such as CT and MRI, as well as tumor marker testing.
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Affiliation(s)
- Sayaka Miyamoto
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yasutaka Ishii
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Masahiro Serikawa
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Tomofumi Tsuboi
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Ken Tsushima
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Shinya Nakamura
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Tetsuro Hirano
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University
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2
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Fahrner R, Dennler SGC, Inderbitzin D. Risk of malignancy in Caroli disease and syndrome: A systematic review. World J Gastroenterol 2020; 26:4718-4728. [PMID: 32884228 PMCID: PMC7445861 DOI: 10.3748/wjg.v26.i31.4718] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/15/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Congenital intrahepatic bile duct dilatation without fibrosis is called Caroli disease (CD), and is called Caroli syndrome (CS) when it has fibrotic and cirrhotic liver morphology. The development of intrahepatic carcinoma is described in both conditions, but the reported incidence varies extensively. Potential risk factors for the malignant transformation were not described. Furthermore, conservative or surgical treatment is performed depending on the extent of cystic malformation, hepatic dysfunction and structural hepatic changes, but little is known about which treatment should be offered to patients with CD or CS and cancer.
AIM To further investigate the malignant transformation in these conditions.
METHODS A systematic review of the current literature until January 2019 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A search using Medline (PubMed) was performed using a combination of Medical Subject Headings terms “caroli disease”, “caroli syndrome”, “tumor”, “malignant”, and “cholangiocarcinoma”. Only human studies published in English were used for this systematic review. The following parameters were extracted from each article: year of publication, type of study, number of patients, incidence of malignant tumor, duration of symptoms, age, sex, diagnostics, identification of tumor, surgical therapy, survival and tumor recurrence.
RESULTS Twelve retrospective studies reporting the courses of 561 patients (53% females) were included in this systematic review. With a mean age of 41.6 years old (range 23 to 56 years old), patients were younger than other populations undergoing liver surgery. Depending on the size of the study population the incidence of cholangiocarcinoma varied from 2.7% to 37.5% with an overall incidence of 6.6%. There were only few detailed reports about preoperative diagnostic work-up, but a multimodal work-up including ultrasound of the liver, computed tomography, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography was used in most studies. Disease duration was variable with up to several years. Most patients had episodes of cholangitis, sepsis, fever or abdominal pain. Tumor detection was an incidental finding of the surgical specimen in most cases because it is currently often impossible to detect tumor manifestation during preoperative diagnostics. Liver resection or liver transplantation was performed depending on the extent of the biliary pathology and additional alterations of the liver structure or function. No postoperative adjuvant chemotherapy was reported, but chemotherapy was administered in selected cases of tumor recurrence. Overall survival rates after one year were low at 36% and a high recurrence rate of up to 75% during the observation period.
CONCLUSION Only few retrospective studies reported a low tumor incidence. Despite the high rate of mortality and tumor recurrence, definite surgical treatment should be offered as soon as possible.
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Affiliation(s)
- René Fahrner
- Department of Surgery, Bürgerspital Solothurn, Solothurn 4500, Switzerland
| | - Sandra GC Dennler
- Department of Surgery, University Hospital Dresden, Dresden 01307, Germany
| | - Daniel Inderbitzin
- Department of Surgery, Bürgerspital Solothurn, Solothurn 4500, Switzerland
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3
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Castro P, Werner H, Matos APP, Peixoto-Filho FM, Andrade CV, Araujo Júnior E. Caroli's syndrome evaluated by ultrasound and magnetic resonance imaging during pregnancy. Ultrasound Obstet Gynecol 2020; 56:125-127. [PMID: 32196798 DOI: 10.1002/uog.22016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 06/10/2023]
Affiliation(s)
- P Castro
- Department of Fetal Medicine, Clínica de Diagnóstico por Imagem (CDPI), Rio de Janeiro, Brazil
- Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - H Werner
- Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - A P P Matos
- Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - F M Peixoto-Filho
- Fetal Medicine Unit, Fernandes Figueira Institute, Rio de Janeiro, Brazil
| | - C V Andrade
- Fetal Medicine Unit, Fernandes Figueira Institute, Rio de Janeiro, Brazil
| | - E Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Medical course, Municipal University of São Caetano do Sul (USCS), Bela Vista Campus, São Paulo, Brazil
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4
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Traisrisilp K, Tongprasert F, Wannasai K, Tongsong T. Giant choledochal cyst and infantile polycystic kidneys as prenatal sonographic features of Caroli syndrome. J Clin Ultrasound 2020; 48:45-47. [PMID: 31584696 DOI: 10.1002/jcu.22778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/09/2019] [Indexed: 06/10/2023]
Abstract
Caroli syndrome is a developmental disorder caused by complete or partial arrest of ductal plate remodeling, leading to dilated bile ducts along with fibrosis surrounding the portal tracts. It is most commonly associated with autosomal recessive polycystic kidney (ARPKD). We report a unique case of Caroli syndrome, diagnosed prenatally at 24 weeks of gestation in a 29-year-old Thai woman. Ultrasound findings revealed the association of a fetal giant choledochal cyst with ARPKD. Autopsy findings showed ductal plate malformation, typical of Caroli syndrome, associated with giant choledocal cyst and ARPKD.
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Affiliation(s)
- Kuntharee Traisrisilp
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Fuanglada Tongprasert
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Komson Wannasai
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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5
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Mamone G, Carollo V, Cortis K, Aquilina S, Liotta R, Miraglia R. Magnetic resonance imaging of fibropolycystic liver disease: the spectrum of ductal plate malformations. Abdom Radiol (NY) 2019; 44:2156-2171. [PMID: 30852632 DOI: 10.1007/s00261-019-01966-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Fibropolycystic liver diseases, also known as ductal plate malformations, are a group of associated congenital disorders resulting from abnormal development of the biliary ductal system. These disorders include congenital hepatic fibrosis, biliary hamartomas, polycystic liver disease, choledochal cysts and Caroli disease. Recently, it has been thought to include biliary atresia in this group of diseases, because ductal plate malformations could be implicated in the pathogenesis of this disease. Concomitant associated renal anomalies can also be present, such as autosomal recessive polycystic kidney disease (ARPKD), medullary sponge kidney and nephronophthisis. These disorders can be clinically silent or can cause abnormalities such as cholangitis, portal hypertension, gastrointestinal bleeding and infections. The different types of ductal plate malformations show typical findings at magnetic resonance (MR) imaging. A clear knowledge of the embryology and pathogenesis of the ductal plate plays a pivotal role to understand the characteristic imaging appearances of these complex diseases. Awareness of these MR imaging findings is central to the detecting and differentiating between various fibropolycystic liver diseases and is important to direct appropriate clinical management and prevent misdiagnosis.
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Affiliation(s)
- Giuseppe Mamone
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Tricomi 5, 90127, Palermo, Italy.
| | - Vincenzo Carollo
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Tricomi 5, 90127, Palermo, Italy
| | - Kelvin Cortis
- Department of Medical Imaging, Mater Dei Hospital, Msida, MSD 2090, Malta
| | - Sarah Aquilina
- Department of Medical Imaging, Mater Dei Hospital, Msida, MSD 2090, Malta
| | - Rosa Liotta
- Pathology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Tricomi 5, 90127, Palermo, Italy
| | - Roberto Miraglia
- Radiology Unit, Department of Diagnostic and Therapeutic Services, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Via Tricomi 5, 90127, Palermo, Italy
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6
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Hasegawa E, Sawa N, Hoshino J, Suwabe T, Hayami N, Yamanouchi M, Sekine A, Hiramatsu R, Imafuku A, Kawada M, Ubara Y, Imamura T, Takaichi K. Recurrent Cholangitis in a Patient with Autosomal Dominant Polycystic Kidney Disease (ADPKD) and Caroli's Disease. Intern Med 2016; 55:3009-3012. [PMID: 27746440 PMCID: PMC5109570 DOI: 10.2169/internalmedicine.55.6818] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/24/2016] [Indexed: 12/12/2022] Open
Abstract
We herein present a rare case of an autosomal dominant polycystic kidney disease (ADPKD) patient with Caroli's disease, a congenital embryonic biliary tree ductal plate abnormality often associated with autosomal recessive polycystic kidney disease. A 76-year-old woman with ADPKD on hemodialysis was admitted to our hospital with recurrent cholangitis and hepatobiliary stones. Caroli's disease was diagnosed according to typical imaging findings of cystic intrahepatic bile duct dilatation and the central dot sign. Hepatobiliary system abnormalities such as Caroli's disease should be considered in febrile ADPKD patients, even in the absence of typical clinical signs or symptoms.
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7
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Abstract
Peribiliary cysts, otherwise known as cystic dilatation of the peribiliary glands, are uncommon, and are usually discovered incidentally at autopsy, or in explants following liver transplantation. Preoperative diagnosis is often difficult owing to their asymptomatic nature and small size. Exclusion of a premalignant or malignant cystic condition is mandatory. We report a case of peribiliary cysts, initially thought to represent Caroli’s disease, and briefly discuss the management of this condition.
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Affiliation(s)
- G Fusai
- Liver Transplant, Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK
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8
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Narsanská A, Treska V, Mírka H, Mukensnabl P, Chlumská A. [Caroli disease--dilatation of intrahepatic bile ducts]. Rozhl Chir 2011; 90:281-284. [PMID: 21838130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Caroli disease is a rare congenital condition characterized by a non-obstructive saccular or fusiform multi-focal segmental dilatation of the intrahepatic bile ducts and the frequent formation of the intrahepatic calculi. It can affect the entire liver with manifestations in the childhood, or only some segments, which may be an asymptomatic condition found accidentally in the adulthood. In other cases, the condition is manifested primarily with tract infections. The authors of the three case reports describe pitafalls of the diagnosis and treatment of the segmental Caroli disease, which is manifested in the adulthood. The treatment was a resection of the affected liver segments.
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9
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Maurea S, Mollica C, Imbriaco M, Fusari M, Camera L, Salvatore M. Magnetic resonance cholangiography with mangafodipir trisodium in Caroli's disease with pancreas involvement. JOP 2010; 11:460-463. [PMID: 20818116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
CONTEXT Caroli's disease is a rare congenital disorder first described by Caroli in 1958. This abnormality consists of non-obstructive, saccular or fusiform dilation of the intrahepatic bile ducts resulting in cystic lesions; similar abnormalities may also occur in the kidneys and pancreas. CASE REPORT We illustrate the role of enhanced mangafodipir trisodium magnetic resonance imaging in a patient with sporadic non-hereditary Caroli's disease associated with pancreatic involvement in which mangafodipir trisodium magnetic resonance imaging characterized part of the cystic liver lesions as saccular dilations of the intrahepatic bile ducts of the left lobe, allowing diagnosis of the disease. CONCLUSION We strongly recommend hepatobiliary magnetic resonance imaging with mangafodipir trisodium in such patients.
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Affiliation(s)
- Simone Maurea
- Department of Biomorphological and Functional Sciences (DSBMF), University Federico II of Napoli (UNINA), Biostructures and Bioimmages Institution (IBB), National Research Council (CNR), Naples, Italy.
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10
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Ruiz HD, Palermo M, Duran G, Ritondale O, Miguel B. [Hepatic cystic lesion]. Acta Gastroenterol Latinoam 2008; 38:4-91. [PMID: 18533349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Hugo Daniel Ruiz
- Servicio de Cirugía General Hospital Nacional Profesor Alejandro Posadas, Villa Sarmiento, El Palomar, Provincia de Bs. As., Argentina.
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11
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Abstract
Caroli's disease is a liver disease with segmental cystic dilatation of the intrahepatic bile ducts. It belongs to the group of congenital ductal plate malformations. With an incidence of only 0.05% of all liver cases in the Liver Registry of the University of Cologne, it is a very rare disorder. Caroli's disease is usually combined with cholangitis and bile duct stones. Control of these infections and maintenance of biliary drainage are the main therapeutic aims. The development of intra epithelial neoplasia and invasive carcinoma are rare complications. We report a case of Caroli's disease with the development of cholangiocarcinoma and review the literature.
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Affiliation(s)
- H-U Kasper
- Institut für Pathologie, Clemenshospital Münster, Düesbergweg 128, 48153, Münster.
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12
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Abstract
Segmentary dilatation of intrahepatic bile ducts are well depicted with ultrasound. Two groups of diseases could be differentiated by searching a liver mass: biliary diseases without any tumor or dilatation of biliary duct due to an adjacent liver mass. Inside these two groups, some diseases are frequent and other not. We will emphasize autoimmune cholangitis and (Low Phospholipid Associated Cholelithiasis) LPAC with MDR3 deficiency. Decisional trees are proposed.
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Affiliation(s)
- M P Vullierme
- Service de Radiologie, Hôpital Beaujon, 100, boulevard du Général-Leclerc, 92118 Clichy.
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13
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Yilmaz S, Kirimlioglu H, Kirimlioglu V, Isik B, Coban S, Yildirim B, Ara C, Sogutlu G, Yilmaz M. Partial hepatectomy is curative for the localized type of Caroli's disease: a case report and review of the literature. Surgeon 2006; 4:101-5. [PMID: 16623167 DOI: 10.1016/s1479-666x(06)80039-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The case of a 58-year-old woman who was diagnosed with the localized type of Caroli's disease is presented. This disease involves the whole of the left half of the liver. A left hepatectomy was followed by complete resolution of symptoms. The current article suggests that hepatic resection may be aggressively performed in selected patients with the localized form of Caroli's disease.
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Affiliation(s)
- S Yilmaz
- General Surgery Department, Inonu University Medical School, Malatya, Turkey.
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14
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Kalita NI, Kotenko OG, Gusev AV, Moshkovskiĭ GI, Vasil'ev OV, Popov AO, Korshak AA, Grinenko AV, Khokhlov AV, Fedorov DA. [Caroli's disease]. Klin Khir 2006:60-2. [PMID: 16826820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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15
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Versaci A, Macrí A, Scuderi G, Certo A, Bottari A, Pantè S, Bonica M, Familiari L. [Caroli's disease: literature review and characteristics of a clinical case]. G Chir 2005; 26:195-200. [PMID: 16184701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The Author's report the case of the simple form of Caroli's disease, a rare malformation, and review literature pointing out the difficulty of an early diagnosis, because disease can be silent for a long time too and it is identified for complication. Today, imaging, endoscopy and interventionist radiology are the most valid tools for a correct diagnosis and treatment, above all in a case of emergency, when other therapeutic solutions are not possible.
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Affiliation(s)
- A Versaci
- Dipartimento di Patologia Umana, Università degli Studi di Messina
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16
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Purandare D, Thakkar H, Lolge S, Purandare N. Intraluminal portal vein sign in Caroli's syndrome. Indian J Gastroenterol 2004; 23:158. [PMID: 15333985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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17
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Hérnandez-Ortiz J, Corona R, Méndez-Sánchez N. Caroli's disease and choledochal cyst. Ann Hepatol 2004; 1:196. [PMID: 15280807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2002] [Indexed: 12/11/2022]
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18
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Romanowicz T, Waga Z, Słomian M, Słomian M, Marczewski K. [Caroli's disease--if so rare clinical problem?]. Pol Merkur Lekarski 2004; 17:92-4. [PMID: 15559623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Jacques Caroli for the first time described in the year 1958, cavernous dilatation of the hepatic bile ducts. It's the rare abnormality; there have been reported less than 200 cases until now. The disease is caused by defects in the genetic program which are transmitted in an autosomal recessive way. There are two basic types of the disease: focal (so called. "simple type") and diffuse, embracing entire bile tree. Both types maybe associated with congenital hepatic fibrosis and then the abnormality is usually called "Grumbach disease". There is an excessive risk of cancer (cholangiocarcinoma) in patients with Caroli's disease. Dominant symptoms are due to recurrent cholangitis, sometimes with signs of portal hypertension. Basic treatment is hepatic resection (focal form) and internal bypass of the biliary tree (diffuse form). The prognosis of the disease is reserved one.
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Affiliation(s)
- Tomasz Romanowicz
- Oddzial Chirurgiczny SP, Szpital Wojewódzki im. Papieza Jana Pawła II w Zamościu
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19
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Boopathy Vijayaraghavan S, Kamalam M, Raman ML. Prenatal sonographic appearance of congenital bile duct dilatation associated with renal-hepatic-pancreatic dysplasia. Ultrasound Obstet Gynecol 2004; 23:609-611. [PMID: 15170806 DOI: 10.1002/uog.1006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report the prenatal sonographic features of congenital bile duct dilatation associated with renal-hepatic-pancreatic dysplasia. The condition was seen at 22 weeks of gestation and led to termination of pregnancy. This is the first description of congenital bile duct dilatation using prenatal sonography. It is also the first report of a case in which the features of dysplasia were evident in all three of the organs which may be affected, the kidneys, liver and pancreas.
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20
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Tamiolakis D, Arvanitidou V, Nikolaidou S, Barbagadaki S, Avgidou K, Boglou P, Papadopoulos N. Caroli's syndrome. A case report and review of the literature. MINERVA GASTROENTERO 2004; 50:179-81. [PMID: 15722989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Personal experience in the treatment of a female patient presenting a pure monolobar Caroli's disease, is described. The woman was asymptomatic so far; during the last 2 weeks she was admitted on 3 occasions with repeated attacks of cholangitis and obstructive jaundice. Surgery was performed for relief of the jaundice. A diagnosis of segmental Caroli's disease (congenital dilatation of intrahepatic bile ducts) with congenital fibrosis was made on the basis of marked fibrous septa with the characteristic ductal plate formation on left hepatectomy specimen and the cysts seen on ultrasound.
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Affiliation(s)
- D Tamiolakis
- Department of Cytopathology, General Hospital of Chania, Crete, Greece
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21
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Sgro M, Rossetti S, Barozzino T, Toi A, Langer J, Harris PC, Harvey E, Chitayat D. Caroli's disease: prenatal diagnosis, postnatal outcome and genetic analysis. Ultrasound Obstet Gynecol 2004; 23:73-76. [PMID: 14971004 DOI: 10.1002/uog.943] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Caroli's disease is a rare autosomal recessive condition characterized by cystic dilatation of the intrahepatic bile ducts and infantile polycystic kidney disease. We report a case with Caroli's disease detected prenatally at 33 weeks' gestation with fetal ultrasound findings of a cystic liver mass and echogenic kidneys. Postnatal investigation confirmed enlarged and echogenic kidneys with dilatation of the intrahepatic bile ducts consistent with the diagnosis of Caroli's disease. Genetic analysis of the gene, PKHD1, associated with autosomal recessive polycystic kidney disease (ARPKD) showed that the patient had compound heterozygous mutations, confirming that this early onset Caroli's disease was part of the spectrum of ARPKD. To our knowledge this is the third case of Caroli's disease detected prenatally and the first in which the infant survived.
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Affiliation(s)
- M Sgro
- Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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22
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Giovanardi RO. Monolobar Caroli's disease in an adult. Case report. Hepatogastroenterology 2003; 50:2185-7. [PMID: 14696493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Caroli's disease is the dilatation of the segmental intrahepatic bile ducts which generally presents in a diffuse form, but may occasionally involve only a single lobe, commonly the left one. We report the case of a 64-year-old male who presented with a clinical picture of obstructive jaundice, with Caroli's disease in segments II and III of the liver. Preoperative diagnosis was made using abdominal ultrasound and computed tomography scan, confirmed by endoscopic retrograde cholangiopancreatography. The treatment used was segmentectomy II and III (left lobectomy--Couinaud's classification) of the liver. Macroscopic examination of the resected specimen revealed cystic dilatation of the intrahepatic bile ducts and intrahepatic lithiasis. Histologically there was no evidence of malignancy. Liver resection is the treatment of choice for Caroli's disease confined to a single lobe or segment, eliminating the potential for cholangitis, lithiasis and carcinoma.
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MESH Headings
- Bile Ducts, Intrahepatic/pathology
- Caroli Disease/diagnostic imaging
- Caroli Disease/pathology
- Caroli Disease/surgery
- Cholangiopancreatography, Endoscopic Retrograde
- Cholestasis, Intrahepatic/diagnostic imaging
- Cholestasis, Intrahepatic/pathology
- Cholestasis, Intrahepatic/surgery
- Diagnosis, Differential
- Hepatectomy
- Humans
- Jaundice, Obstructive/diagnostic imaging
- Jaundice, Obstructive/pathology
- Jaundice, Obstructive/surgery
- Liver/pathology
- Liver Function Tests
- Male
- Middle Aged
- Tomography, X-Ray Computed
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Affiliation(s)
- Rafael Omar Giovanardi
- Department of Surgery, Fundação Universidade de Caxias do Sul, Department of Surgery, Hospital Geral, Caxias do Sul, Centro Hepatobiliar, Caxias do Sul, Brazil.
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Abe H, Miyakawa Y, Nagatsuma K, Kitahara T, Aizawa R, Kimura N, Matsuoka M, Aizawa Y, Toda G. [A case of Caroli's disease which DIC-CT was useful to a definite diagnosis]. Nihon Shokakibyo Gakkai Zasshi 2003; 100:1129-33. [PMID: 14524240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Hiroshi Abe
- Division of Gastroenterology and Hepatology, Jikei University Aoto Hospital
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24
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Ozkur A, Ozkiliç S, Zincirkesen S. [Complex type Caroli disease: radiologic findings]. Tani Girisim Radyol 2003; 9:122-4. [PMID: 14661316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- Ayhan Ozkur
- Gaziantep Universitesi Tip Fakültesi, Radyodiagnostik Anabilim Dali, Gaziantep
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Espinoza R, San Martín S, Court F, Vera E, Ferreira R, Croxatto H. [Hepatic resection in localized Caroli disease]. Rev Med Chil 2003; 131:183-9. [PMID: 12708257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Caroli disease is a cystic congenital malformation of the intrahepatic biliary tract, frequently associated with lithiasis. Commonly, cystic dilatations are bilateral and infrequently they affect only one hepatic lobule or segment. We report six patients with localized Caroli disease, three in the right and three in the left hepatic lobule, that were subjected to a hepatic resection. There were no postoperative complications or mortality. After 28 months of follow up, patients are asymptomatic and with normal hepatic function and ultrasonography. The importance of diagnosing localized Caroli disease, in which hepatic resection can be curative, is emphasized.
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Affiliation(s)
- Ricardo Espinoza
- Servicios de Cirugía, Radiología y Anatomía Patológica y Unidad de Endoscopia, Hospital Parroquial de San Bernardo, Facultad de Medicina, Universidad de los Andes.
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Abstract
OBJECTIVE The purpose of our study was to describe the spectrum of radiologic and pathologic features of Caroli's disease. CONCLUSION Caroli's disease and its complications have overlapping radiologic appearances that reflect the underlying pathology of fibrosis, ductal dilatation, cholangitis, stone formation, and malignancy.
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Affiliation(s)
- Angela D Levy
- Department of Radiologic Pathology, Armed Forces Institute of Pathology, M-121, 6825 16th St. N.W., Washington, DC 20306-6000, USA
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27
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Garre C, Mercader J, García B, Sáez R, Albaladejo A, Baños R. [Segmental Caroli's disease]. Rev Esp Enferm Dig 2002; 94:504-5. [PMID: 12486859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Ninan VT, Nampoory MRN, Johny KV, Gupta RK, Schmidt I, Nair PM, Al-Ali J. Caroli's disease of the liver in a renal transplant recipient. Nephrol Dial Transplant 2002; 17:1113-5. [PMID: 12032206 DOI: 10.1093/ndt/17.6.1113] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chiba T, Shinozaki M, Kato S, Goto N, Fujimoto H, Kondo F. Caroli's disease: central dot sign re-examined by CT arteriography and CT during arterial portography. Eur Radiol 2002; 12:701-2. [PMID: 11870491 DOI: 10.1007/s003300101048] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Rompelman SE, Hart W, Koopmans RP. [Clinical thinking and decision making in practice. 4 times ERCP, 6 times ultrasonography of the upper abdomen and 3 CT-scans for a woman with recurrent fever and bacteremia]. Ned Tijdschr Geneeskd 2001; 145:2264-70. [PMID: 11760606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
A 42-year-old woman was hospitalised due to recurrent fever (40 degrees C) and bacteraemia. A physical examination revealed no abnormalities. Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Enterococci were found in blood cultures. Laboratory results revealed liver enzyme levels which were only slightly elevated. An X-ray investigation, ERCPs, CT scans, ultrasounds, a leucocyte scintigram and a gallium scan, all revealed no abnormalities. Due to the results from the blood cultures it was thought that the bile duct system or the digestive tract were the focus of infection. Therefore a liver biopsy was carried out for the purpose of making a diagnosis. The patient was diagnosed as having ductal plate malformation, a microscopic congenital cystic dilatation of the bile ducts. The prognosis is poor and the treatment consists of lifelong antibiotics.
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Affiliation(s)
- S E Rompelman
- Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Inwendige Geneeskunde, Meibergdreef 9, 1105 AZ Amsterdam
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32
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Nichitaĭlo ME, Skums AV, Galochka IP. [Diagnosis and treatment of cystic transformation of biliary ducts]. Klin Khir 2001:22-7. [PMID: 11833318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Experience of surgical treatment of 58 patients with cystic transformation of biliary ducts of various type was presented. There were adduced tactics of examination of the patients, kinds of operative treatment, postoperative complications were analyzed. In 33 patients there was performed resection of cystically-changed common biliary duct and subsequent formation of hepaticojejunoanastomosis with the jejunal loop, excluded according to Roux method. Late results of treatment of patients were studied. Malignization in cystic wall was revealed in 2 (3.4%) of patients. One patient died.
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Affiliation(s)
- A S Fulcher
- Department of Radiology, Medical College of Virginia of Virginia Commonwealth University, 401 N 12th St, PO Box 980615, Richmond, VA 23298-0615, USA.
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Affiliation(s)
- T E Herman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
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Waechter FL, Sampaio JA, Pinto RD, Alvares-da-Silva MR, Cardoso FG, Francisconi C, Pereira-Lima L. The role of liver transplantation in patients with Caroli's disease. Hepatogastroenterology 2001; 48:672-4. [PMID: 11462899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Caroli's disease, characterized by segmental or diffuse dilation of the intrahepatic biliary ducts, is a rare disease which is difficult to treat. The course of the disorder is characterized by recurrent episodes of cholangitis and hospital stays, with a consequent loss of quality-of-life and productive capacity, often ending in death due to uncontrolled infection. Endoscopic drainage of the bile duct, percutaneously or surgically, is palliative, and presents bad results in the follow-up of these patients. Orthotopic liver transplantation appears to be an effective curative option for the treatment of patients with Caroli's disease associated to complications. The authors present the course of two cases of this disease, associated with congenital fibrosis of the liver worsened by repeated episodes of cholangitis, submitted to orthotopic liver transplantation.
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Affiliation(s)
- F L Waechter
- Liver Transplantation Program, Surgery and Gastroenterology Department, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brasil.
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Rickes S, Neye H, Wirth J, Ortner M, Lochs H, Wermke W. Improved accuracy in the diagnosis of intrahepatic bile duct ectasia in Caroli's disease by combination of ultrasound and endoscopic retrograde cholangiography. Ultraschall Med 2000; 21:223-225. [PMID: 11126603 DOI: 10.1055/s-2000-7988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Caroli's disease is characterized by dilatation of the intrahepatic bile ducts. Cholangitis, liver cirrhosis and development of a cholangiocarcinoma are possible complications. For optimal therapy, a correct diagnosis of the extent of the disease is mandatory. The present report demonstrates that the combination of endoscopic retrograde cholangiography and ultrasound may lead to a more reliable diagnosis of the extent of Caroli's disease. It is therefore essential to perform ultrasound in all these patients.
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Affiliation(s)
- S Rickes
- Dept. of Gastroenterology, Hepatology and Endocrinology, University Hospital Charité (Campus Mitte), Berlin, Germany.
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Abstract
The authors report on an infant who had a multiloculated cystic lesion located in segment IV of the liver, consistent with Caroli's disease diagnosed, by routine prenatal ultrasound at 25 weeks' gestation, and confirmed by hepatobiliary HIDA scan and computed tomography soon after birth. Because there was no sign of biliary obstruction, the patient was observed initially, with gradual regression of the cysts noted by serial sonograms. Caroli's disease in older children and adults often is associated with recurrent cholangitis and cirrhosis, mandating resection when the disease is unilobar. However, the natural history of Caroli's disease diagnosed in utero is unclear, and a period of observation appears warranted in the asymptomatic patient.
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Affiliation(s)
- I Bratu
- Division of Pediatric Surgery, The Montreal Children's Hospital, Quebec, Canada
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Abstract
We describe a case of Caroli's disease associated with a choledochal cyst and autosomal recessive polycystic kidney disease in a child whose diagnosis was confirmed with magnetic resonance cholangiopancreatography (MRCP), after initial abnormalities were seen by ultrasonography. Invasive procedures such as liver biopsy or endoscopic retrograde cholangiopancreatography (ERCP) were, therefore, not necessary. Recent radiological advances in the diagnosis of Caroli's disease with particular emphasis on MRCP are discussed.
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Affiliation(s)
- S Z Hussain
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201-2196, USA
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Honoré P, Detry O, Meurisse M, Jacquet N. [Image of the month. Cholangiography of biliary duct cystic dilatation idiopathic of Caroli's disease]. Rev Med Liege 1999; 54:509. [PMID: 10446517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- P Honoré
- Service de Chirurgie abdominale, Université de Liège
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Abstract
PURPOSE The aim of this study was to describe the authors' experience with Caroli's disease in children and adolescents. METHODS The authors reviewed the hospital charts of 10 children and adolescents with Caroli's disease diagnosed between 1968 and 1996. RESULTS The median age at the onset of symptoms was 5.5 months and the median age at diagnosis was 12 months, both much lower than those reported in the literature. Clinical symptoms were compatible with the classical findings of Caroli's disease, but jaundice and hepatosplenomegaly occurred more frequently. There was an association with congenital renal malformation in eight cases (80%), congenital hepatic fibrosis in five cases, and choledochal cyst in two cases. One case presented the pure form of the disease.
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Affiliation(s)
- R B Pinto
- Department of Pediatric Gastroenterology, Hospital de Clínicas and Santa Casa de Misericórdia, Porto Alegre, Rio Grande do Sul, Brazil
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Affiliation(s)
- O Akin
- Baskent University School of Medicine, Bahcelievler, Ankara, Turkey
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Abstract
PURPOSE We examined the intracystic flow pattern and portal hemodynamics with Doppler sonography in patients with Caroli's disease. METHODS Sonographic characteristics and portal hemodynamics were studied by color Doppler sonography and spectral analysis in 5 patients (4 children and 1 adult) with Caroli's disease using high-frequency transducers. Caroli's disease was associated with infantile polycystic kidney disease in 4 patients and congenital hepatic fibrosis in 2 patients. Four patients had no clinical or imaging evidence of portal hypertension. The adult patient had congenital hepatic fibrosis and portal hypertension. RESULTS Color Doppler sonograms and spectral analyses disclosed distinctive hepatic arterial and portal venous flow within the fibrovascular projections in the bile ducts of all the children. The adult with advanced portal hypertension presented with a no-flow state in the intracavitary part of the portal vein and a strong arterial signal related to disturbed hemodynamics in the arterialized liver. CONCLUSIONS The fact that portal hemodynamics change over time should be taken into account when Doppler assessment of Caroli's disease is attempted. Doppler sonographic monitoring of the portal system to indirectly diagnose and follow the progression of so-called congenital hepatic fibrosis may be an effective alternative to liver biopsy.
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Affiliation(s)
- W Gorka
- Department of Medical Imaging, King Fahad National Guard Hospital, Riyadh, Saudi Arabia
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Hayashi H, Odaka T, Okuda K. Hepatobiliary and pancreatic imaging. Patient. Carolis disease. J Gastroenterol Hepatol 1998; 13:658, 665. [PMID: 9715412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Breysem L, Opdenakker G, Smet M, Uyttebroeck A, Marchal G, Baert AL. Caroli's syndrome. J Belge Radiol 1998; 81:1-2. [PMID: 9563264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We report the case of a two-year-old girl presenting with recurrent episodes of fever and hepatomegaly. High resolution ultrasound (US) and computed tomography (CT) of the liver show dilated intrahepatic bile ducts with bridge formation and intraluminal protrusions. The extrahepatic bile duct is normal. The diagnosis of irregular dilated bile ducts with signs of cholangitis and cholangiolitis is proved by liver biopsy. The histologically associated congenital liver fibrosis in our patient enter into the Caroli's syndrome. We illustrate the high resolution US and the CT findings in this case.
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Affiliation(s)
- L Breysem
- Department of Radiology, University Hospital, Leuven, Belgium
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Abstract
Magnetic resonance cholangiopancreatography (MRCP) has received much attention in the recent literature as a noninvasive alternative to endoscopic retrograde cholangiography, primarily for biliary calculus disease, but also for the less common indication of evaluation of biliary anomalies. We present a case of Caroli's disease in which the diagnosis can be clearly inferred by MRCP. The findings of MRCP and endoscopic retrograde cholangiopancreatography are similar. This new procedure could be a noninvasive alternative to direct cholangiography and perhaps will become the first-choice imaging technique for diagnosing Caroli's disease.
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Affiliation(s)
- T Asselah
- Department of Hepatogastroenterology, Hôpital Huriez, Centre Hospitalier Universitaire de Lille, France
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Abstract
We report a case of Caroli's disease associated with diverticulae and choledochocele of the common bile duct, a wide pancreaticobiliary angle and non-cirrhotic portal hypertension. This patient presented with recurrent episodes of cholangitis. To our knowledge, such a range of findings in the same patient has not been previously reported in the English language literature.
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Affiliation(s)
- R Gupta
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Ahmadi T, Itai Y, Minami M. Central dot sign in entities other than Caroli disease. Radiat Med 1997; 15:381-4. [PMID: 9495788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this study was to describe central dot sign (tiny dots with strong contrast enhancement of the portal vein within dilated hepatic bile ducts on computed tomography) in entities other than Caroli disease, especially in peribiliary cysts with or without autosomal-dominant polycystic kidney disease. MATERIALS AND METHODS Computed tomography in 74 cases of peribiliary cysts and 134 cases of other liver diseases and states possibly showing central dot sign were retrospectively reviewed to examine the central dot sign. RESULTS In three cases of peribiliary cysts, some part of the liver showed strongly enhanced portal radicles surrounded completely or partially by low-attenuation, enlarged peribiliary cysts, presenting "central dot sign" on contrast-enhanced computed tomography. CONCLUSION We suggest that in addition to Caroli disease, some other entities and diseases of the liver may demonstrate central dot sign and this sign should not be considered a specific finding of Caroli disease.
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Affiliation(s)
- T Ahmadi
- Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
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Seth AK, Chawla Y, Dhiman RK, Gupta S, Suri S, Dilawari JB. Caroli's disease: a central dot means a lot. Trop Gastroenterol 1997; 18:165-6. [PMID: 9612099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We present here a patient of congenital non-obstructive focal dilatation of intrahepatic biliary radicles (Caroli's disease). The peculiar configuration of dilated intrahepatic biliary channels with central portal vein radicles was picked up sonologically as the 'central dot' sign. Awareness of this sign allows an accurate diagnosis without resorting to more invasive and expensive investigations.
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Affiliation(s)
- A K Seth
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Torra R, Badenas C, Darnell A, Brú C, Escorsell A, Estivill X. Autosomal dominant polycystic kidney disease with anticipation and Caroli's disease associated with a PKD1 mutation. Rapid communication. Kidney Int 1997; 52:33-8. [PMID: 9211343 DOI: 10.1038/ki.1997.300] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is the most common renal hereditary disorder. Clinical expression of ADPKD shows interfamilial and intrafamilial variability. We screened for mutations the 3' region of the PKD1 gene, from exon 43 to exon 46, in a family showing anticipation and Caroli's disease and have found a 28 base pairs deletion in exon 46 (12801del28) and a new DNA variant in exon 43 (12184 C to G conserving Ala 3991) segregating with the disease. The mutation should result in a protein 44 amino acids longer then the wild-type PKD1. This PKD1 mutation manifests as typical adult-onset disease in the father, but in the proband, a 26-year-old man, ADPKD was diagnosed as a newborn and was associated with Caroli's disease at the age of 18 years. A renal biopsy performed in childhood disclosed a predominance of glomerular cysts. Mutation 12801del28 is the first molecular defect associated with Caroli's disease and the PKD1 phenotype. The finding of the same mutation in two different members of the same family with different expression of the disease indicates that the phenotypic variation in ADPKD must be due to modifying factors that may radically affect the course of the disease.
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Affiliation(s)
- R Torra
- Nephrology Service, Hospital Clinic, Barcelona, Spain
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Lai FM, Paramsothy M, Goh KL, Boey C. Caroli's disease: functional diagnosis using 99mTc diethyl-iminodiacetic acid (IDA) hepatobiliary scintigraphy. Singapore Med J 1997; 38:164-5. [PMID: 9269396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A case of Caroli's disease is presented and the findings of various imaging modalities are discussed with emphasis on the role of Technetium 99mTc diethyl-iminodiacetic acid scan in reaching the final diagnosis. The 'beaded' appearance of the dilated intrahepatic ducts seen in this scan is believed to be pathognomonic for this condition.
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Affiliation(s)
- F M Lai
- Division of Nuclear Medicine, University Hospital Kuala Lumpur, Malaysia
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