Abstract
BackgroundPatients with cirrhosis-associated hepatocellular carcinoma (HCC) rarely present with acute pancreatitis (AP) and obstructive jaundice as the main clinical features. AP with obstructive jaundice caused by common bile duct embolism (CBDE) is very rare.Case presentationA 54-year-old man with CBDE was misdiagnosed with common bile duct stones three times over a 7-month period. Investigations during this time did not identify CBDE. Surgical exploration was performed because of AP, obstructive jaundice, and a tumor in the left lobe of the liver. CBDE from the hepatic tumor was diagnosed by intraoperative biopsy and frozen section examination. The patient underwent left hemihepatectomy, cholecystectomy, and bile duct exploration.ConclusionPreoperative diagnosis of CBDE is difficult because of the rarity of the condition, lack of physician awareness, and easy misdiagnosis on imaging examinations. Early and accurate diagnosis of this condition is important.
Highlights
Patients with cirrhosis-associated hepatocellular carcinoma (HCC) rarely present with acute pancreatitis (AP) and obstructive jaundice as the main clinical features
AP with obstructive jaundice caused by common bile duct embolism (CBDE) is very rare
We report a rare case of CBDE causing AP with obstructive jaundice, to raise awareness of the importance of early and accurate diagnosis
Summary
We have described a very rare case of HCC presenting as AP with obstructive jaundice. Preoperative diagnosis is difficult, because of the rarity of the condition, lack of physician awareness, and easy misdiagnosis on imaging examinations. It is important to pay attention to the above-mentioned clinical data to obtain early and accurate diagnosis of this condition. Consent Written informed consent was obtained from the patient for the publication of this case presentation and accompanying images. Competing interests The authors declare that they have no competing interests. Authors’ contributions GQJ and DSB wrote the manuscript. GQJ, DSB, and JJQ performed the surgery. JJQ, JY, and SJJ helped with the final editing of the manuscript. GQJ and JJQ contributed to this work.
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