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Bilioenteric bypass stricture type II with hepatolithiasis: A case report.

ABSTRACT: Introduction:Secondary hepatolithiasis can occur as a result of bilioenteric stenosis or biliary anastomosis stenosis. The incidence of secondary hepatolithiasis appears to increase with increasing rates of hepatobiliary surgery. Here we report the first reported case of secondary hepatolithiasis. Case presentation:A 57-year-old female patient complaining of jaundice all over the body since two years ago. The jaundice was intermittent and progressive. There was a history of previous bilioenteric bypass hepaticojejunostomy Roux-en-Y due to common bile duct cyst. On investigation, we found obstructive jaundice due to stricture of bilioenteric anastomosis type II after bilioenteric bypass hepaticojejunostomy Roux-en-Y with hepatolithiasis type II LR, according to the Takada classification. We did laparotomy found bilateral hepatic duct dilatation, we make incision and remove multiple stones. And then, we performed choledochoscope and confirm total occlusion of tract to distal common hepatic duct. We performed reconstruction Roux-en-Y hepaticojejunostomy with stenting. During the follow-up period, our patients were disease-free. Conclusion:Stricture of bilioenteric anastomosis were successfully treated by surgical reconstruction Roux-en-Y hepaticojejunostomy and stenting. This management has a good outcome and could be an effective alternative to surgery.

SUBMITTER: Warsinggih

PROVIDER: S-EPMC7484961 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Bilioenteric bypass stricture type II with hepatolithiasis: A case report.

Warsinggih Fajar Amir A Labeda Ibrahim I Uwuratuw Julianus Aboyaman JA Prihantono Faruk Muhammad M

Annals of medicine and surgery (2012) 20200711

<h4>Introduction</h4>Secondary hepatolithiasis can occur as a result of bilioenteric stenosis or biliary anastomosis stenosis. The incidence of secondary hepatolithiasis appears to increase with increasing rates of hepatobiliary surgery. Here we report the first reported case of secondary hepatolithiasis.<h4>Case presentation</h4>A 57-year-old female patient complaining of jaundice all over the body since two years ago. The jaundice was intermittent and progressive. There was a history of previo ...[more]

PMID: 32953096

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Project description:BACKGROUND:Hunter syndrome (mucopolysaccharidosis type II) is a recessive X-linked disorder due to mutations in the iduronate 2-sulfatase (IDS) gene. The IDS gene encodes a lysosomal enzyme, iduronate 2-sulfatase. The disease occurs almost exclusively in males. However, in the literature, 12 cases of the disease in females are known due to structural anomalies, a non-random chromosome X inactivation or chromosome X monosomy. The purpose of this article is to demonstrate a rare case of Hunter syndrome in a girl caused by a mutation in the IDS gene inherited from the mother and the presence of chromosome X of paternal origin, partially deleted in the long arm region - 46,X,del(X)(q22.1). CASE PRESENTATION:Girl M., 4?years old, entered the hospital with growth retardation, pain in the lower limbs, and joint stiffness, noted from the age of 18?months. After the karyotype analysis, which revealed a partial deletion of the long arm of chromosome X - 46, X, del (X) (q 22.1), Turner syndrome was diagnosed. However, due to the hurler-like facial phenotype, Hurler syndrome or type I mucopolysaccharidosis (MPS) was suspected. The study of lysosomal enzymes showed normal alpha-L-iduronidase activity and a sharp decrease in the activity of iduronate sulfatase in the blood: 0.001??M/l/h, at a rate of 2.5-50??M/l/h. Molecular genetic analysis revealed a hemizygous deletion in the IDS gene, which was not registered in the international Human Gene Mutation Database (HGMD) professional. This deletion was not detected in the girl's father, but was detected in her mother in the heterozygous state. CONCLUSIONS:Thus, the girl confirmed comorbidity - Turner syndrome with a partial deletion of the long arm of chromosome X of paternal origin, affecting the Xq28 region (localization of the IDS gene), and Hunter syndrome due to a deletion of the IDS gene inherited from the mother. The structural defect of chromosome X in the girl confirmed the hemizygous state due to the mutation in the IDS gene, which has led to the formation of the clinical phenotype of Hunter syndrome.

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Bilioenteric bypass stricture type II with hepatolithiasis: A case report.

Publications

Bilioenteric bypass stricture type II with hepatolithiasis: A case report.

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