Displaying publications 41 - 60 of 110 in total

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  1. Improved biliary detection and diagnosis through intelligent machine analysis
    Logeswaran R
    Comput Methods Programs Biomed, 2012 Sep;107(3):404-12.
    PMID: 21194781 DOI: 10.1016/j.cmpb.2010.12.002
    This paper reports on work undertaken to improve automated detection of bile ducts in magnetic resonance cholangiopancreatography (MRCP) images, with the objective of conducting preliminary classification of the images for diagnosis. The proposed I-BDeDIMA (Improved Biliary Detection and Diagnosis through Intelligent Machine Analysis) scheme is a multi-stage framework consisting of successive phases of image normalization, denoising, structure identification, object labeling, feature selection and disease classification. A combination of multiresolution wavelet, dynamic intensity thresholding, segment-based region growing, region elimination, statistical analysis and neural networks, is used in this framework to achieve good structure detection and preliminary diagnosis. Tests conducted on over 200 clinical images with known diagnosis have shown promising results of over 90% accuracy. The scheme outperforms related work in the literature, making it a viable framework for computer-aided diagnosis of biliary diseases.
    Matched MeSH terms: Bile Duct Diseases/diagnosis; Bile Duct Diseases/therapy
  2. Screening of lactobacillus strains against salmonella both isolated from malaysian free-range chicken intestine for use as probiotic
    Wan Mohtar Wan Yusoff, Hutari A, Jaseem WS, Aidil Abdul Hamid
    Sains Malaysiana, 2011;40:1115-1122.
    A total of eight strains of Lactobacillus and two strains of Salmonella were isolated from free-range Malaysian chickens intestine. Evaluation based on in vitro studies included aggregation, co-aggregation, growth with bile salts, tolerance to acidic pH, and inhibitory activity were carried out. The isolated Lactobacillus were Lactobacillus fermentum IA, Lactobacillus fermentum IB, Lactobacillus fermentum IC, Lactobacillus fermentum ID, Lactobacillus salivarius subsp. salicinus IE, Lactobacillus salivarius subsp. salicinus IF, Lactobacillus salivarius subsp. salivarius IG, and Lactobacillus spp. IH. The corresponding isolated Salmonella were Salmonella spp. 3B21 and Salmonella spp. 1A12. The ability of aggregation and also tolerance to pH 2.5 are found in Lactobacillus fermentum ID, Lactobacillus salivarius subsp. salicinus IF, Lactobacillus salivarius subsp. salivarius IG, and Lactobacillus spp. IH. The isolate most resistance to 1% bile salts is Lactobacillus fermentum ID but observed to be weak in inhibitory activity against Salmonella spp. The best co-aggregation and strongest inhibitory activity against Salmonella spp. was observed in Lactobacillus salivarius subsp. salivarius IG. Despite being not so resistant in the presence of bile salts 0.5 and 1% (w/v), the lag time in the presence of bile salts 0.3% (w/v) of Lactobacillus salivarius subsp. salivarius IG and also for Lactobacillus spp. IH are the shortest. Based on good aggregation properties, the best co-aggregation, tolerance to acidic pH 2.5 and bile salts 0.3% (w/v) and strongest inhibitory activity against Salmonella spp., Lactobacillus salivarius subsp. salivarius IG comes out as the best candidate as probiotic for chicken.
    Matched MeSH terms: Bile Acids and Salts
  3. Fulltext Observational study on cannulation rate during ERCP at hospital alor setar
    Sivasubramaniam M, Naidu RR
    Malays J Med Sci, 2001 Jan;8(1):25-30.
    PMID: 22973152 MyJurnal
    ERCP (Endoscopic Retrograde Cholangiopancreaticography) was introduced in this hospital in late 1995. Since then, a lot of improvement have been achieved in the management of biliary tract diseases. Various general surgeons posted to this hospital have been trained in this procedure. A study was done to include all patients admitted for ERCP from August 1998 to July 1999. A total of 322 new patients with a mean of 26.9 cases a month had underwent this procedure. The duration of cannulation varied from 2 minutes to 45 minutes with a mean of 12 minutes. Cannulation rate by various surgeons differed. Overall success rate was 80%. Mortality was 0.6 % and morbidity was 0.9%. ERCP is safe and it takes at least 6 months of regular duodenoscopy before one can master the technique. Achieving 80% cannulation rate, has definitely reduced unnecessary common bile duct (CBD) explorations. During this study we have trained various surgeons in this procedure and at least 2 surgeons could be credentialled according to the guidelines provided by the Malaysian Society of Gastroenterology and Hepatology. During this study we have identified various reasons for the failure of cannulation which are useful for future training of endoscopists.
    Matched MeSH terms: Common Bile Duct
  4. Fulltext Bilio-enteric anastomoses: results in benign and malignant conditions
    Toufeeq Khan TF, Lwin M, Ulah S, Zahari A, Mokti I
    Singapore Med J, 1993 Dec;34(6):545-50.
    PMID: 8153721
    Twenty bilio-enteric anastomoses were performed or managed from May 1990 to December 1992. Recurrent pyogenic cholangitis (RPC) and pancreatic cancer were the commonest conditions which required drainage procedures. Roux-en-Y hepatico-jejunostomy (RHJ) was performed in 9 patients, 4 for RPC, one for pancreatic cancer, another for a cholangiocarcinoma, 2 following excision of choledochal cyst and one hepatico-jejunostomy was part of a Whipple reconstruction. Roux-en-Y side to side choledocho-jejunostomy (CDJ) was performed in one patient. Choledocho-duodenostomy (CDD) was performed in 6, 4 for obstructive jaundice due to choledocholithiasis, one for RPC and one in a choledochal cyst. One patient operated elsewhere presented with complications after a CDD. Palliative cholecysto-jejunostomy (CYJ) was carried out in 4 patients with pancreatic malignancy. All benign conditions were treated by hepatico-jejunostomy and choledocho-duodenostomy, while three patients with malignant conditions were treated by hepatico-jejunostomy. Permanent subcutaneous access loops were provided when recurrent problems were anticipated, 4 in RPC and one after subtotal resection of a cholangiocarcinoma. Based on this study, we found Roux-en-Y hepatico-jejunostomy a versatile drainage procedure, which was useful in both benign and malignant diseases.
    Matched MeSH terms: Common Bile Duct/surgery*; Common Bile Duct Diseases/surgery*
  5. Fulltext Survival of commercial probiotic strains to pH and bile
    International Food Research Journal, 2011;18(4):1515-1522.
    MyJurnal
    This study was performed to enumerate the total viable cell count of probiotic in five brands (A to E) of commercially cultured milk drinks that are available in the Malaysian market as well as to test their tolerance to various pH and bile concentrations by simulating the human gastrointestinal pH and bile concentration. The acid tolerance test was studied under pH 1.5 and 3.0 with 7.2 as control. The cell count for the acid tolerance test was obtained at an interval of 0, 1.5 and 3 hours respectively and was plated onto duplicate MRS agars to be incubated at 37°C for 48 hours. All cells recovered after 3 hours of pH treatment were selected for bile tolerance test in MRS broth containing bile concentrations of 0% (control), 0.3% and 2.0% and cell counts were recorded after 24 hours of incubation. The probiotic strains in products A, B, C & D met the suggested initial count of 106 CFU/ml with brand C recording the highest at 9.19 ± 0.14 log CFU/ml. Strains in product A, B & C showed good tolerance to pH 3.0 and 7.2 recording a count of >106 CFU/ml after 3 hours with a range of 6.60 – 9.04 log CFU/ml. The higher bile concentrations resulted in lower growth of strains in all the brands. Upon pH 1.5 treatment, only brand C recorded growth in all bile concentrations. After pH 3.0 treatment, all brands except brand E met the requirement of survival at 0.3% bile concentration. Results showed probiotics in product A, B & C met the initial count requirement, and exhibited good acid and bile tolerance therefore being a potentially good source of probiotic.
    Matched MeSH terms: Bile
  6. Biomagnification of endocrine disrupting chemicals (EDCs) by Pleuronectes yokohamae: Does P. yokohamae accumulate dietary EDCs?
    Nurulnadia MY, Koyama J, Uno S, Amano H
    Chemosphere, 2016 Feb;144:185-92.
    PMID: 26363319 DOI: 10.1016/j.chemosphere.2015.08.059
    We evaluated the potential for biomagnification of endocrine disrupting chemicals (EDCs) such as nonylphenol (NP), octylphenol (OP), bisphenol A (BP), and natural estrogens such as estrone (E1) and 17β-estradiol (E2) in a benthic fish, Pleuronectes yokohamae. The assimilation efficiencies (AE) of most EDCs ranged from 88 to 96% suggesting that they were efficiently incorporated and assimilated into P. yokohamae, except for NP (50%). However, the biomagnification factor (BMF) values were <1.0 suggesting that the compounds were not biomagnifying. Additionally, three of the target EDCs were not detected (BP, E1 and E2). Glucuronidation activity towards BP (11.44 ± 2.5 nmol/mg protein/min) and E2 (12.41 ± 3.2 nmol/mg protein/min) was high in the intestine suggesting that EDCs were glucuronidated prior to excretion into bile. Thus, we conclude that biomagnification of dietary EDCs is reduced in P. yokohamae because of effective glucuronidation.
    Matched MeSH terms: Bile
  7. Fulltext Bile Acids: Physiological Activity and Perspectives of Using in Clinical and Laboratory Diagnostics
    Shansky Y, Bespyatykh J
    Molecules, 2022 Nov 13;27(22).
    PMID: 36431930 DOI: 10.3390/molecules27227830
    Bile acids play a significant role in the digestion of nutrients. In addition, bile acids perform a signaling function through their blood-circulating fraction. They regulate the activity of nuclear and membrane receptors, located in many tissues. The gut microbiota is an important factor influencing the effects of bile acids via enzymatic modification. Depending on the rate of healthy and pathogenic microbiota, a number of bile acids may support lipid and glucose homeostasis as well as shift to more toxic compounds participating in many pathological conditions. Thus, bile acids can be possible biomarkers of human pathology. However, the chemical structure of bile acids is similar and their analysis requires sensitive and specific methods of analysis. In this review, we provide information on the chemical structure and the biosynthesis of bile acids, their regulation, and their physiological role. In addition, the review describes the involvement of bile acids in various diseases of the digestive system, the approaches and challenges in the analysis of bile acids, and the prospects of their use in omics technologies.
    Matched MeSH terms: Bile Acids and Salts
  8. Intrahepatic cholestasis of pregnancy: from an obstetrician point of view
    Abdelhafez MMA, Ahmed KAM, Than WW, Baharuddin DMP, Kadir F, Jeffree S, et al.
    J Obstet Gynaecol, 2022 Oct;42(7):2550-2557.
    PMID: 35666947 DOI: 10.1080/01443615.2022.2081801
    Intrahepatic cholestasis of pregnancy (ICP) is the commonest among the specific dermatoses of pregnancy. The disease is characterised by intense pruritus and specifically by elevated bile acid levels and owing to the rarity of data published in this context, the disease carries a great challenge in both diagnosis and management. The disease is associated with significant maternal as well as perinatal adverse effects, hence, this article aims at improving the knowledge of the women's health carers with the up-to-date and evidence-based, whenever possible, recommendations while managing patients with ICP.
    Matched MeSH terms: Bile Acids and Salts
  9. Endoscopic sphincterotomy with balloon dilatation versus sphincterotomy alone for common bile duct stones removal: a randomised controlled trial
    Ooi JS, Ikhwan SM, Azem Fathi MA, Leow VM, Syed Hassan AZ
    Med J Malaysia, 2024 Mar;79(2):133-140.
    PMID: 38553916
    INTRODUCTION: Endoscopic sphincterotomy (EST) plus endoscopic papillary large balloon dilatation (EPLBD) has been reported as a valid alternative to EST alone in removing common bile duct (CBD) stone. The aim of this study is to compare efficacy, and safety of these two groups of patients in removing CBD stone in Hospital Universiti Sains Malaysia (HUSM).

    MATERIALS AND METHODS: This is a prospective single centre randomised single blinded comparative study conducted in HUSM. The primary endpoints for this study are the overall complete stone clearance rate and complication rate, while the secondary outcome for this study are duration of procedure and rate of usage of adjunct methods. Objective data analysis is conducted using independent sample t-test and chi-squared test.

    RESULTS: A total of 66 patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis which is CBD stone. 34 patients were allocated to EST plus EPLBD arm (n=34), and 32 patients were in EST alone arm (n=32) using randomisation method. For intention to treat, patients from EST alone arm that unable to achieve complete stone clearance will be switched to EST plus EPLBD arm. The overall complete stone removal rate for both groups were comparable (EST plus EPLDB: 100% versus EST alone: 93.8%; p= 0.139). The two patients from EST alone group (6.2%) that unable to achieve complete stone clearance were converted to EST plus EPLBD group for intention to treat and able to achieve complete stone clearance by EST plus EPLBD. For procedural time, both arms are comparable as well (EST plus EPLDB: 15.8 minutes vs EST alone: 15.5 minutes; p= 0.860). Complications such as pancreatitis occurred in one patient in EST plus EPLBD arm (EST plus EPLDB: 2.9 % vs EST alone: 0 %; p= 0.328), and bleeding occurred in one patient in EST alone arm (EST plus EPLDB: 0 % vs EST alone: 3.1 %; p= 0.299) , but it is not statistically significant. No perforation or cholangitis complication occurred in both groups. No adjunct usage was observed in both groups.

    CONCLUSION: In this study with limited sample size, both EST plus EPLBD and EST alone are effective and has comparable procedural time in removing CBD stone. Even though both methods are equally effective, EPLBD plus EST is an alternative solution if complete stone clearance is unable to achieve via EST alone.

    Matched MeSH terms: Common Bile Duct
  10. Fulltext Cholangiocarcioma in a cat
    Lim, M.L., Watanabe, M.
    Jurnal Veterinar Malaysia, 2016;28(1):16-19.
    MyJurnal
    A 7-year-old, intact female Domestic Shorthair cat was referred to University Veterinary Hospital (UVH), UPM for diagnostic workup of a hepatomegaly observed on abdominal radiographs. Physical examination revealed no significant findings except for a distended abdomen. Hematology and serum biochemistry findings included a regenerative anaemia, left shift neutrophilia and a 10-fold elevation in gamma-glutamyltranspeptidase (GGT). Abdominal ultrasound revealed heterechoic liver lobes with irregular margins and presence of nodular and cyst-like structures predominantly affecting the left lobes. A mild ascites was also noted. A fine needle aspiration of the liver was performed and cytology results confirmed a cholangiocarcinoma. Generally, the outcome for cholagiocarcinoma is poor and there is limited information regarding the prognosis for patients with cholangiocarcinoma following chemotherapy or surgery.
    Matched MeSH terms: Bile Duct Neoplasms; Bile Ducts, Intrahepatic
  11. In vitro assessment of pediococci- and lactobacilli-induced cholesterol-lowering effect using digitally enhanced high-performance thin-layer chromatography and confocal microscopy
    Syakila RN, Lim SM, Agatonovic-Kustrin S, Lim FT, Ramasamy K
    Anal Bioanal Chem, 2019 Feb;411(6):1181-1192.
    PMID: 30680424 DOI: 10.1007/s00216-018-1544-2
    The cholesterol-lowering properties of 12 lactic acid bacteria (LAB) in the absence or presence of 0.3% bile salts were assessed and compared quantitatively and qualitatively in vitro. A new, more sensitive and cost-effective high-performance thin-layer chromatography method combined with digital image evaluation of derivatised chromatographic plates was developed and validated to quantify cholesterol in LAB culture media. The performance of the method was compared with that of the o-phthalaldehyde method. For qualitative assessment, assimilated fluorescently tagged cholesterol was visualised by confocal microscopy. All LAB strains exhibited a cholesterol-lowering effect of various degrees (19-59% in the absence and 14-69% in the presence of bile salts). Lactobacillus plantarum LAB12 and Pentosaceus pentosaceus LAB6 were the two best strains of lactobacilli and pediococci. They lowered cholesterol levels by 59% and 54%, respectively, in the absence and by 69% and 58%, respectively, in the presence of bile salts. Confocal microscopy showed that cholesterol was localised at the outermost cell membranes of LAB12 and LAB6. The present findings warrant in-depth in vivo study. Graphical abstract (A) 3D plots based on scan at 525 nm of (B) derivatized HPTLC plate of separated cholesterol and (C) confocal microscopic image showing the localisation of NBD-cholesterol assimilated by LAB.
    Matched MeSH terms: Bile Acids and Salts/metabolism
  12. Fulltext Prediagnostic Plasma Bile Acid Levels and Colon Cancer Risk: A Prospective Study
    Kühn T, Stepien M, López-Nogueroles M, Damms-Machado A, Sookthai D, Johnson T, et al.
    J Natl Cancer Inst, 2020 May 01;112(5):516-524.
    PMID: 31435679 DOI: 10.1093/jnci/djz166
    BACKGROUND: Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans.

    METHODS: Associations between prediagnostic plasma levels of 17 primary, secondary, and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Bile acid levels were quantified by tandem mass spectrometry in samples from 569 incident colon cancer cases and 569 matched controls. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) for colon cancer risk across quartiles of bile acid concentrations.

    RESULTS: Positive associations were observed between colon cancer risk and plasma levels of seven conjugated bile acid metabolites: the primary bile acids glycocholic acid (ORquartile 4 vs quartile 1= 2.22, 95% confidence interval [CI] = 1.52 to 3.26), taurocholic acid (OR = 1.78, 95% CI = 1.23 to 2.58), glycochenodeoxycholic acid (OR = 1.68, 95% CI = 1.13 to 2.48), taurochenodeoxycholic acid (OR = 1.62, 95% CI = 1.11 to 2.36), and glycohyocholic acid (OR = 1.65, 95% CI = 1.13 to 2.40), and the secondary bile acids glycodeoxycholic acid (OR = 1.68, 95% CI = 1.12 to 2.54) and taurodeoxycholic acid (OR = 1.54, 95% CI = 1.02 to 2.31). By contrast, unconjugated bile acids and tertiary bile acids were not associated with risk.

    CONCLUSIONS: This prospective study showed that prediagnostic levels of certain conjugated primary and secondary bile acids were positively associated with risk of colon cancer. Our findings support experimental data to suggest that a high bile acid load is colon cancer promotive.

    Matched MeSH terms: Bile Acids and Salts/blood*
  13. Fulltext Caroli's disease: functional diagnosis using 99mTc diethyl-iminodiacetic acid (IDA) hepatobiliary scintigraphy
    Lai FM, Paramsothy M, Goh KL, Boey C
    Singapore Med J, 1997 Apr;38(4):164-5.
    PMID: 9269396
    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.
    Matched MeSH terms: Bile Ducts, Intrahepatic/radionuclide imaging*
  14. Endoscopic intervention for hepatolithiasis associated with sharp angulation of right intrahepatic ducts
    Mahadeva S, Prabakharan R, Goh KL
    Gastrointest Endosc, 2003 Aug;58(2):279-82.
    PMID: 12872105
    Hepatolithiasis (intrahepatic stones) is common in Asian patients. Hepatolithiasis with intrahepatic strictures and sharp ductal angulation poses a particularly difficult management problem.
    Matched MeSH terms: Bile Ducts, Intrahepatic/pathology*
  15. Fulltext Intrahepatic stones: the UKM experience
    Din J, Qureshi A, Daud A, Ahmad H
    Med J Malaysia, 2000 Dec;55(4):473-7.
    PMID: 11221160
    Intrahepatic stones remain a major source of morbidity and mortality. With improving techniques in hepatobiliary surgery, the management and the outcome of intrahepatic calculi is reviewed. Forty-nine cases referred from all over Malaysia between January 1993 to June 1996 were analyzed retrospectively. There were thirty-two females and seventeen males. The median age was 46 years. Biliary diseases encountered in association with intrahepatic calculi included benign strictures (n = 14), ascariasis (n = 3), cholangiocarcinoma (n = 1), Caroli's disease (n = 1), and thalassaemia, (n = 1), fifty-six percent of stones were located in both the intrahepatic ducts while 34% were found in the left intrahepatic duct. Thirty-one patients underwent common bile duct exploration either alone or in combination with liver resection or bilioenteric anastomosis. Despite the various combinations of surgical and non-surgical intervention 28 (57.1%) patients had residual stones. Despite the availability of newer techniques in hepatobiliary surgery, residual stones were common, resulting in higher treatment costs.
    Matched MeSH terms: Bile Duct Diseases/complications
  16. Fulltext Anomalous pancreatico-biliary junction--a non-dilated biliary system and gallbladder carcinoma
    Toufeeq Khan TF, Hayat FZ, Muniandy S
    Singapore Med J, 1998 Jan;39(1):25-6.
    PMID: 9557100
    Anomalous pancreatico-biliary junction (APBJ) is commonly associated with cystic dilatation of the bile ducts but recently, several cases without the cystic dilatation have been reported. We treated a young female patient with intractable back and epigastric pain of three months duration. The spine was normal on magnetic resonance imaging (MRI), but several lymph nodes were seen around the coeliac axis. An APBJ, a non-cystic biliary system, non-filling of the gallbladder and an irregular right margin of the bile duct were evident on endoscopic retrograde pancreatography (ERCP), which was highly suggestive of gallbladder (GB) malignancy. At surgery, the GB was hard with local infiltration of the bile duct. Numerous large para-aortic and supraduodenal lymph nodes were present and only a biopsy was possible. Details of the case are presented and the growing etiological importance of an APBJ, especially without cystic biliary dilatation in gallbladder carcinogenesis is discussed.
    Matched MeSH terms: Common Bile Duct/abnormalities*
  17. Gall bladder tumour, choledochal cyst and an anomalous pancreatico-biliary junction
    Toufeeq Khan TF, Sherazi ZA, Tan YY
    HPB Surg, 1995 Jun;8(3):185-6.
    PMID: 7547622
    This report highlights the association of a tumour in an acalculous gall bladder with an anomalous pancreatico-biliary junction (PBJ) and a type IVa choledochal cyst. Cholecystectomy and Rouxen-Y hepatico-jejunostomy (RHJ) was performed after division of the common bile duct (CBD) and excision of the dilated segment. The details of the case are presented and the role of an abnormal PBJ in gall bladder carcinogenesis is discussed.
    Matched MeSH terms: Common Bile Duct/abnormalities*
  18. Acid and bile tolerance of Lactobacillus isolated from chicken intestine
    Jin LZ, Ho YW, Abdullah N, Jalaludin S
    Lett Appl Microbiol, 1998 Sep;27(3):183-5.
    PMID: 9750324
    Twelve Lactobacillus strains isolated from chicken intestine were used to investigate acid and bile tolerance in vitro. Ten out of the 12 strains were slightly affected by 0.3% bile salts, showing a delay of growth (d) of 0.6-37.2 min compared with growth in control cultures. Two strains were not affected by the bile salts. Of the 12 strains, seven could be arbitrarily classified as resistant (d < 15 min) and five as tolerant (15 min < d < or = 40 min). Lactobacillus strains from the caecum showed better tolerance to acid than those from the ileum. Generally, the survival of the ileal strains was very low at pH 1.0 and 2.0, and moderate at pH 3.0. In contrast, caecal Lactobacillus strains could survive at pH 1.0 for up to 2 h of incubation; growth was moderate at pH 2.0 and good at pH 3.0 and 4.0.
    Matched MeSH terms: Bile Acids and Salts/pharmacology*
  19. Type IVa choledochal cysts: surgical management and literature review
    Thambi Dorai CR, Visvanathan R, McAll GL
    Aust N Z J Surg, 1991 Jul;61(7):505-10.
    PMID: 1859310
    Type IVa choledochal cysts with cylindrical dilatation of the intrahepatic ducts constitute a relatively less recognized variety of choledochal cysts, and differ from cystic dilatation of intrahepatic ducts in their clinical manifestations and response to treatment. Five patients with type IVa choledochal cysts and cylindrical dilatation of major intrahepatic ducts who underwent cyst excision and Roux-en-Y hepaticojejunostomy are reported. The duration of symptoms was less than 1 year in all patients. Palpable abdominal mass and abdominal pain were present in 3 patients. The traid of jaundice, abdominal pain and mass was present in only 1 patient. The intrahepatic dilatation regressed after excision of the extrahepatic cyst just below the hilum of the liver. The surgical technique is described and the need for excision of the cyst is emphasized.
    Matched MeSH terms: Bile Ducts/pathology*
  20. Biliary ascariasis: a wandering worm
    Lim, C.B., Munirah, A., Alias, M., Nandy, A.K., Thamby Dorai, C.R.
    Malaysian Journal of Paediatrics and Child Health, 2000;12(1):68-71.
    MyJurnal
    Ascaris lumbricoides infection usually results in mild gastrointestinal symptoms. However, heavy worm load infections can cause major complications. In one-third of the latter cases, the worms enter the bile duct causing cholangitis, biliary colic and acute pancreatitis. We describe an eleven-year-old Indian boy who presented with high grade fever, vomiting of worms, jaundice and right hypochondria! pain. Examination revealed an ill, malnourished and jaundiced child. His abdomen was tender with positive Murphy's sign and hepatomegaly. Urgent ultrasound showed hepatomegaly with dilated intrahepatic and common bile ducts (CBD). There were tubular echogenic filling defects with central sonolucency along the long axis of the CBD. He was fasted, started on intravenous fluids and broad spectrum antibiotics. As there was no improvement after 24 hours, endoscopic retrograde cholangio-pancreaticography (ERCP) was performed: it showed worms in the CBD. A stent was inserted to decompress the bile ducts and to ensure biliary drainage. The patient improved, the fever settled, jaundice resolved, serum amylase and transaminase levels normalised. It was planned to remove the stent at a later date.
    Matched MeSH terms: Bile Ducts; Common Bile Duct
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