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Endoscopy 2003; 35(5): 446-450
DOI: 10.1055/s-2003-38779
Case Report
© Georg Thieme Verlag Stuttgart · New York

Diagnosis and Treatment of Biliary Obstruction Caused by Portal Cavernoma

J.  Dumortier 1 , E.  Vaillant 1 , O.  Boillot 1 , G.  Poncet 1 , L.  Henry 1 , J.-Y.  Scoazec 2 , C.  Partensky 1 , P.-J.  Valette 1 , P.  Paliard 1 , T.  Ponchon 1
  • 1 Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Lyon, France
  • 2 Service Central d’Anatomie et Cytologie Pathologiques, Hôpital Edouard Herriot, Lyon, France
Further Information

Publication History

Submitted 11 April 2002

Accepted after Revision 8 October 2002

Publication Date:
17 April 2003 (online)

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While hemorrhagic complications of portal cavernoma are frequent, compression of the bile ducts by portal cavernoma is uncommon and treatment is still a matter for debate. We report here six new cases in order to describe: (a) the clinical, biological, and morphological features of this condition, and (b) the long-term results of a combined endoscopic and surgical treatment. The median age of patients at the time of diagnosis was 36.5 years. The circumstances of diagnosis were acute cholangitis (n = 3), asymptomatic biological cholestasis (n = 1), pruritus, jaundice and asthenia (n = 1) and jaundice alone (n = 1). Portal cavernoma and bile duct dilatation were confirmed by abdominal ultrasonography with pulsed color doppler and endoscopic retrograde cholangiography (ERC). Gallstones were found in four patients. Following stenting of the bile duct, there was a good outcome in two patients. In four patients, after failure of prolonged endoscopic treatment, second-line surgical portal-systemic shunting allowed removal of the biliary stent, and no recurrence of disease. In conclusion, biliary involvement in portal cavernoma is now a well-recognized entity, and our results suggest that combined endoscopic and surgical treatment could be required.

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J. Dumortier, M.D., Ph.D.

Pavillon H

Hôpital Edouard Herriot · 69437 Lyon Cedex 03 · France ·

Fax: + 33-4-72110147

Email: jerome.dumortier@chu-lyon.fr

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