The choledocian syndrome it is a clinical-humoral syndrome characterized by jaundice, choluria, and acholia, increased bilirubin, cholesterol, and alkaline phosphatase. These symptoms are largely caused by generalized obstruction of the extra-hepatic bile duct. Such a definition may not say much to those unfamiliar with medical language, so I try to briefly explain some definitions.
The word "humoral" comes from "humors", which is what is related to the fluids of the body. By "jaundice" I mean yellowing of the skin or eyes due to excess bilirubin.
On the other hand, "coluria" is when the urine has a dark color due to the excretion of excess bilirubin, and "acholia" when there is a notable absence of bile secretion by the liver..
Haddad (1961) defines choledochal syndrome as “a process that leads to obstruction of the passage of bile flow that is located in the common bile duct. This manifests itself through calculations, inflammations, parasites, and even tumors ".
This condition is diagnosed by a simple history plus a routine physical exam. The cause can even be determined with a proper diagnosis. To do this, the doctor must interpret the medical history and thus obtain the data to combat the syndrome, which often must be operated on..
Symptoms of choledochal syndrome include:
In addition, we must pay attention to spider veins that appear on the skin, which represent the rupture of blood vessels, and abdominal pain, especially if they are on the right side..
The causes of choledocian syndrome are many and varied. It may be due to the presence of tumors, a narrowing of the bile duct (known as stenosis), stones in the common bile duct, inflammation, tumors or pseudocysts in the pancreas, pressure on the bile ducts by a mass or tumor nearby or primary sclerosing cholangitis.
Other causes include alcohol-related liver disease, amyloidosis, bacterial abscess in the liver, exclusively intravenous feeding, lymphomas, pregnancy, primary biliary cirrhosis, liver cancer, either primary or metastatic , sarcoidosis, tuberculosis, viral hepatitis, and serious infections that have spread through the blood (known as sepsis).
The main thing to detect the choledocian syndrome is to pay attention to the tests that indicate biochemical alterations in blood, urine, bile flow and stool:
Bilirubin is generally in the blood in a ratio of 0.2 to 1 mg. When the bile exceeds the pressure of 30 centimeters, the bile flow stops working, thus dilating and rupturing the intralobular and perilobular ducts.
Urine usually presents with a brownish-dark color, which in general stains the clothes of patients. Bilirubin is also detected in the urine.
The color of the stool is putty, mainly due to the lack of eterobilin. There may also be an increase in neutral fats due to a lack of secretion, or an abundance of fatty acids.
The main treatment for cysts is complete biliary obstruction surgery to restore continuity to the gastrointestinal tract..
Excision has different treatments for each cyst, as can be seen below:
On the other hand, the prognosis for those who suffer from choledocian syndrome largely depends on the cause of the disease. As already mentioned, the stones can be removed by surgery and that cures the cholestasis. Stents (prostheses) may also be placed to open ducts blocked by tumors..
That said, there are certain complications that arise from choledocian syndrome. Some of them are diarrhea, organ failure, poor absorption of fat and fat-soluble vitamins, intense itching, weak bones (also called osteomalacia).
Therefore, if you suffer from constant and strong itching, if the eyes and / or skin are yellow, consult a doctor immediately..
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