Massive Hepatomegaly Secondary to Amyloidosis with Normal Liver Chemistries.

Amyloid light chain (AL) amyloidosis is a disease of misfolded, fibrous proteins, either kappa or lambda subtype, that can be deposited into one or more organs, caused by a proliferation of plasma cells. The liver is uncommonly the main organ system affected and rarely the only organ affected by amyloid deposition. With hepatic involvement, the most common presenting findings are hepatomegaly and elevation of serum alkaline phosphatase.

Marked coagulopathy without liver disease or anticoagulation therapy.

Symptomatic coagulopathies in celiac disease (CD) are rare. Here, we report a profound case of coagulopathy in a celiac. A 66-year old female without liver disease or anti-coagulation therapy presented with multiple ecchymoses, guaiac positive melanic stool, and a recent 4.

Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones.

Background And Aims: Endoscopic retrograde cholangiopancreatography is commonly performed to remove bile duct stones. The aim of this study was to determine short-term outcomes of endoscopic balloon dilation of the sphincter of Oddi compared with sphincterotomy for stone extraction.

Methods: A randomized, controlled multicenter study of 117 patients assigned to dilation and 120 to sphincterotomy was performed in a spectrum of clinical and academic practices.

Biliary obstruction.

Preview In a state-of-the art medical center, stones in the bile duct can be fragmented with stone-crushing baskets or electro- hydraulic or laser probes passed through an endoscope. Or they can be snared in a basket catheter inserted through a T-tube tract and guided by fluoroscopy. Expanding metallic mesh stents are being developed for use in biliary strictures and may have prolonged patency.