Dersleri yüzünden oldukça stresli bir ruh haline sikiş hikayeleri bürünüp özel matematik dersinden önce rahatlayabilmek için amatör pornolar kendisini yatak odasına kapatan genç adam telefonundan porno resimleri açtığı porno filmini keyifle seyir ederek yatağını mobil porno okşar ruh dinlendirici olduğunu iddia ettikleri özel sex resim bir masaj salonunda çalışan genç masör hem sağlık hem de huzur sikiş için gelip masaj yaptıracak olan kadını gördüğünde porn nutku tutulur tüm gün boyu seksi lezbiyenleri sikiş dikizleyerek onları en savunmasız anlarında fotoğraflayan azılı erkek lavaboya geçerek fotoğraflara bakıp koca yarağını keyifle okşamaya başlar
Biliary Papillomatosis - A Rare Cause of Recurrent Cholangitis and Biliary Obstruction | OMICS International
ISSN: 2161-069X
Journal of Gastrointestinal & Digestive System

Like us on:

Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on Medical, Pharma, Engineering, Science, Technology and Business

Biliary Papillomatosis - A Rare Cause of Recurrent Cholangitis and Biliary Obstruction

Kam Juinn Huar1*, Chan Chung Yip1, Khor Jen Lock Christopher2 and Tan Meng Yew Damien2

1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Level 5 Academia, 20 College Road, Singapore

2Department of Gastroenterology and Hepatology, Singapore General Hospital, Level 5 Academia, 20 College Road, Singapore

*Corresponding Author:
Kam Juinn Huar
Associate Consultant
Department of HPB and
Transplant Surgery SingaporeGeneral Hospital
Level 5 Academia 20 College Road, Singapore
Tel: 6563265563
Fax: 6562209323
E-mail: [email protected]

Received date: March 12, 2015, Accepted date: March 13, 2015, Published date: March 20, 2015

Citation: Huar KJ, Yip CC, Christopher KJL, Damien TMY (2015) Biliary Papillomatosis - A Rare Cause of Recurrent Cholangitis and Biliary Obstruction. J Gastrointest Dig Syst 5:I103. doi:10.4172/2161-069X.1000i103

Copyright: © 2015 Haur K et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Gastrointestinal & Digestive System

Medical Image

Biliary papillomatosis is a rare bile duct pathology with papillary adenomatous growth of varying extent involving intra and extrahepatic biliary system. It may present with obstructive jaundice or cholangitis. Biliary imaging may show multiple filling defects. This may be mistaken as multiple biliary stones which often present concomitantly. Biliary papillomatosis is a premalignant condition and surgical resection provides the best form of curative treatment for suitable patients. In our patient, the preoperative histological diagnosis of high grade dysplasia was obtained from ERCP. The papillomatous growth has involved left hepatic duct proximally and distally into ampulla of Vater as shown in MRCP and endoscopy. The patient underwent left hepatectomy and pylorus preserving pancreaticoduodenectomy successfully (Figures 1-4).


Figure 1: T2 weighted MRI showing slightly hyperintense intraductal soft tissue masses that extend into left hepatic duct and distal CBD.


Figure 2: ERCP showing ductal trifurcation and dilated biliary tree with multiple filling defects in the main bile duct that extend into left hepatic duct.


Figure 3: Endoscopy showing papillomatous growth involving ampulla of Vater.


Figure 4: Ductal cholangioscopy showing papillomatous growth within CBD.

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Article Usage

  • Total views: 13255
  • [From(publication date):
    April-2015 - Jan 27, 2023]
  • Breakdown by view type
  • HTML page views : 9018
  • PDF downloads : 4237