Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis
ObjectiveEosinophilic cholangitis (EC) is an uncommon form of benign biliary obstruction. It frequently eludes accurate clinical diagnosis, leading to inappropriate treatment methods. It is our aspiration that this clinical report will impart comprehensive insights into EC and, specifically, the cri...
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1340667/full |
| _version_ | 1797353600983236608 |
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| author | Xiao-Ning Huang Qi-Min Fang Yu-Feng Zhong Jing Liu |
| author_facet | Xiao-Ning Huang Qi-Min Fang Yu-Feng Zhong Jing Liu |
| author_sort | Xiao-Ning Huang |
| collection | DOAJ |
| description | ObjectiveEosinophilic cholangitis (EC) is an uncommon form of benign biliary obstruction. It frequently eludes accurate clinical diagnosis, leading to inappropriate treatment methods. It is our aspiration that this clinical report will impart comprehensive insights into EC and, specifically, the critical role of tomographic examination.Case summaryA 34-year-old man was urgently admitted to the hospital due to excruciating abdominal distress persisting for several hours. Following a six-day course of anti-inflammatory therapy, his symptoms displayed marginal improvement, prompting his discharge. He returned to the hospital a month later for re-examination on doctor’s orders. Based on the results of the re-examination, the patient refused steroid hormone shock therapy and subsequently underwent laparoscopic left-lateral hepatic lobectomy in order to confirm the diagnosis. The preoperative absolute counts of eosinophils in the peripheral blood were documented as 2.3 × 109/L, 3.06 × 109/L, and 1.50 × 109/L consecutively; concurrently, the corresponding percentages of eosinophils were quantified at levels of 21.90%, 30.70%, and 19.20%. The subsequent postoperative pathological assessment unveiled EC as the definitive diagnosis. The patient has since remained free from disease recurrence and is presently alive.ConclusionWhen encountering a patient presenting with persistent elevation in absolute eosinophil count in peripheral blood, coupled with imaging manifestations suggestive of intrahepatic periductal inflammation, diagnosis of EC should be highly suspected. The most optimal diagnostic and therapeutic workflow for EC could entail CT-guided liver lesion biopsy, ensued by glucocorticoid pulse therapy, and finally, short-term monitoring utilizing CT or MRI (including T1WI, T2WI, DWI, CEMRI) techniques. |
| first_indexed | 2024-03-08T13:33:22Z |
| format | Article |
| id | doaj.art-6815f2e4a92c448387b441cf33f6e4ca |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-08T13:33:22Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-6815f2e4a92c448387b441cf33f6e4ca2024-01-17T04:17:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-01-011010.3389/fmed.2023.13406671340667Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitisXiao-Ning Huang0Qi-Min Fang1Yu-Feng Zhong2Jing Liu3Department of Radiology, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Radiology, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Radiology, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, ChinaDepartment of Pathology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, ChinaObjectiveEosinophilic cholangitis (EC) is an uncommon form of benign biliary obstruction. It frequently eludes accurate clinical diagnosis, leading to inappropriate treatment methods. It is our aspiration that this clinical report will impart comprehensive insights into EC and, specifically, the critical role of tomographic examination.Case summaryA 34-year-old man was urgently admitted to the hospital due to excruciating abdominal distress persisting for several hours. Following a six-day course of anti-inflammatory therapy, his symptoms displayed marginal improvement, prompting his discharge. He returned to the hospital a month later for re-examination on doctor’s orders. Based on the results of the re-examination, the patient refused steroid hormone shock therapy and subsequently underwent laparoscopic left-lateral hepatic lobectomy in order to confirm the diagnosis. The preoperative absolute counts of eosinophils in the peripheral blood were documented as 2.3 × 109/L, 3.06 × 109/L, and 1.50 × 109/L consecutively; concurrently, the corresponding percentages of eosinophils were quantified at levels of 21.90%, 30.70%, and 19.20%. The subsequent postoperative pathological assessment unveiled EC as the definitive diagnosis. The patient has since remained free from disease recurrence and is presently alive.ConclusionWhen encountering a patient presenting with persistent elevation in absolute eosinophil count in peripheral blood, coupled with imaging manifestations suggestive of intrahepatic periductal inflammation, diagnosis of EC should be highly suspected. The most optimal diagnostic and therapeutic workflow for EC could entail CT-guided liver lesion biopsy, ensued by glucocorticoid pulse therapy, and finally, short-term monitoring utilizing CT or MRI (including T1WI, T2WI, DWI, CEMRI) techniques.https://www.frontiersin.org/articles/10.3389/fmed.2023.1340667/fulleosinophilic cholangitishypereosinophilic syndromebile ductglucocorticoidprimary sclerosing cholangitisprimary biliary cholangitis |
| spellingShingle | Xiao-Ning Huang Qi-Min Fang Yu-Feng Zhong Jing Liu Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis Frontiers in Medicine eosinophilic cholangitis hypereosinophilic syndrome bile duct glucocorticoid primary sclerosing cholangitis primary biliary cholangitis |
| title | Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis |
| title_full | Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis |
| title_fullStr | Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis |
| title_full_unstemmed | Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis |
| title_short | Case report: Rare benign obstructive disease of the biliary tract—a rare case of eosinophilic cholangitis |
| title_sort | case report rare benign obstructive disease of the biliary tract a rare case of eosinophilic cholangitis |
| topic | eosinophilic cholangitis hypereosinophilic syndrome bile duct glucocorticoid primary sclerosing cholangitis primary biliary cholangitis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1340667/full |
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