Biliary - Wallstent, malignant CBD mass, DACP
Comments: This 75 year old man with unresectable gall bladder cancer, status post Wallstent placement 3.5 months previously, is now referred with a fever and rise in liver function tests. Note the purulent debris issuing from the ampullary orifice. Using a balloon catheter, a cholangiogram is obtained. This demonstrates an obstruction in the proximal portion of the Wallstent. The DACP scope is used to further define the nature of this obstruction. At the proximal end of the stent, stone debris is seen in association with tissue overgrowth. It cannot be determined by visualization, whether this tissue overgrowth is due to intimal hyperplasia, or recurrent tumor. The bifurcation was examined and found to be uninvolved. The remainder of the Wallstent also appeared uninvolved. There is no evidence of intimal hyperplasia through the interstices of the Wallstent. A plastic stent is then placed to maintain Wallstent patency.
| Contributed by: |
Brenna C. Bounds, M.D. Assistant Professor of Medicine Harvard Medical School Massachusetts General Hospital |
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Citation: Bounds, BC (Dec 04 2003). Biliary - Wallstent, malignant CBD mass, DACP. The DAVE Project. Retrieved Feb, 9, 2010, from http://daveproject.org/viewfilms.cfm?film_id=21 Times viewed since Feb 2006: 4226 |
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