ENDOSCOPY, cilt.55, ss.637-638, 2023 (SCI-Expanded)
A 5-year-old girl presented with jaundice
and loss of appetite. Physical examination
revealed that she had a palpable
liver 4cm below the right costal arch.
There were no ascites, cervical adenopathy,
or splenomegaly. Laboratory values
showed elevated liver enzymes and
direct bilirubin.
After ultrasound and magnetic resonance
cholangiopancreatography examinations,
parasites and sludge were considered.
Endoscopic retrograde cholangiopancreatography
(ERCP) was initially
performed, and when adequate patency
was achieved after sphincterotomy, the
procedure was continued with a transnasal
scope. The first pathology report
showed an epithelial fragment of the
intestinal mucosa and necrobiotic material.
Cholestasis improved rapidly after
the procedure.
The common bile duct was cannulated
with a transnasal scope, biopsies were
taken, and new stents were inserted during
the second ERCP. Abdominal computed
tomography and magnetic resonance
imaging were unremarkable