dc.contributor.author |
Siriwardana, R.C. |
|
dc.contributor.author |
Jayatunge, D.S.P. |
|
dc.contributor.author |
Ekanayake, C.S. |
|
dc.contributor.author |
Tilakaratne, S. |
|
dc.contributor.author |
Niriella, M.A. |
|
dc.contributor.author |
Gunetilleke, B. |
|
dc.contributor.author |
Dassanayake, A.S. |
|
dc.date.accessioned |
2020-10-14T08:12:31Z |
|
dc.date.available |
2020-10-14T08:12:31Z |
|
dc.date.issued |
2020 |
|
dc.identifier.citation |
Egyptian Liver Journal. 2020; 10(1): 46 |
en_US |
dc.identifier.issn |
2090-6218 (Electronic) |
|
dc.identifier.issn |
2090-6226 |
|
dc.identifier.uri |
http://repository.kln.ac.lk/handle/123456789/21422 |
|
dc.description |
Indexed in Scopus; Not Indexed in MEDLINE |
en_US |
dc.description.abstract |
BACKGROUND: Cholestasis is due to the obstruction at any level of the excretory pathway of bile. One particularly troublesome symptom of cholestasis is pruritus which leads to a profound effect on a patient’s quality of life. In children with progressive familial intrahepatic cholestasis (PFIC), medical treatment often fails. An alternative surgical procedure using biliary diversion offers significant relief for intractable pruritus in non-responders. CASE PRESENTATION: A 43-year-old male presented with a history of persistent jaundice and intractable pruritus for a 2-month duration. His liver enzymes were markedly elevated. However, his liver synthetic function was preserved. After extensive evaluation, a cause for cholestasis was not identified. A multi-disciplinary decision was to consider liver transplantation, but as his liver synthetic functions were remarkably preserved and the intractable pruritus was the sole indication for a transplantation, it was finally decided that internal biliary diversion should be done for symptomatic relief. His pruritus dramatically improved at 6 weeks post-operative. His liver enzymes and bilirubin levels also decreased compared to his pre-operative status. Currently, his liver functions are being closely monitored. CONCLUSION: Though it is not used in adults, the experience of biliary diversion in children with PFIC shows that there is a considerable improvement of symptoms and postpone the need for a transplant. In our patient, liver function and bilirubin as expected did not show a major improvement. But the dramatic improvement of the symptoms gave us the time to postpone the liver transplantation. A biliary diversion is a reasonable option that needs to be considered even in adults with refectory pruritus due to cholestasis. |
en_US |
dc.language.iso |
en_US |
en_US |
dc.publisher |
Springer Nature |
en_US |
dc.subject |
Cholestasis, Intrahepatic |
en_US |
dc.subject |
Cholestasis, Intrahepatic-complications |
en |
dc.subject |
Pruritus |
en |
dc.subject |
Liver transplantation |
|
dc.title |
Internal biliary diversion to avoid liver transplantation in an adult with intractable pruritus due to idiopathic intrahepatic cholestasis |
en_US |
dc.type |
Article |
en_US |