Klatskin tumors and other cholangiocarcinoma - Lieberman's ...

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Differential Diagnosis: Painless Jaundice Unconjugated hyperbilirubinemia Increased bilirubin production (i.e. hemolysis) Hyperbilirubinemia Impaired hepatic bilirubin uptake (i.e. Gilbert’s) Impaired bilirubin conjugation (i.e. Crigler-Najjar) Conjugated Hyperbilirubinemia Hepatocellular injury/ Intrahepatic cholestasis (i.e. viral hepatitis) Biliary Obstruction 4
Patient KR: Conjugated Hyperbilirubinemia Jaundice is physical manifestation of hyperbilirubinemia greater than 2mg/dL. Conjugated bilirubin (direct bilirubin) has already been filtered from the bloodstream into hepatocytes and conjugated to glucuronic acid. Our patient had a conjugated hyperbilirubinemia (his direct bilirubin was markedly elevated and constituted a large portion of his total bilirubin). Conjugated hyperbilirubinemia is due to either hepatocellular injury (preventing excretion of bilirubin from hepatocytes into the biliary system), or biliary obstruction (obstructing flow of bile into the GI tract). Thus, conjugated bilirubin builds up and backs into the bloodstream. 5
Page 1 and 2: Klatskin tumors and other cholangio
Page 3: Index Patient: KR 53M presented to
Page 7 and 8: Review of Biliary Anatomy Plate 260
Page 9 and 10: Patient KR: Biliary Dilatation on R
Page 11 and 12: Patient KR: Hilar Stricture on ERCP
Page 13 and 14: Patient KR: Bile Duct Dilatation an
Page 15 and 16: Cholangiocarcinoma: Pathogenesis an
Page 17 and 18: Common Clinical Manifestations Sym
Page 19 and 20: Bismuth-Corlette Classification Hi
Page 21 and 22: Surgical resection is the only cura
Page 23 and 24: Criteria for Resectability of Hilar
Page 25 and 26: Example of Unresectable Tumor: Celi
Page 27 and 28: Discussion of Companion Patients 27
Page 29 and 30: Patient 2: Hyper-enhancement on Del
Page 31 and 32: Patient 2: Gallbladder Wall Invasio
Page 33 and 34: Patient 3: Liver Metastasis on HAST
Page 35 and 36: Summary (1) Cholangiocarcinoma can
Page 37 and 38: References Anderson C and stuart K

Klatskin tumors and other cholangiocarcinoma - Lieberman's ...

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