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- W2146972933 abstract "In April, 2008, a 68-year-old man presented to us with pruritus and painless jaundice. 2 years earlier, he had developed aortic stenosis and undergone replacement of a bicuspid aortic valve and his dilated ascending aorta. Preoperative assessment showed extensive mediastinal and hilar lymphadenopathy. A lymph node obtained at the time of his surgery showed follicular hyperplasia. Pathology of the aorta was recorded as chronic sclerosing aortitis. 1 year later, he developed nodular, painless swellings in both submandibular regions. A diagnosis of sialadenitis was made. The submandibular gland swelling waxed and waned but remained largely asymptomatic. When he presented to us, total bilirubin was 88·92 μmol/L (normal <20·52 μmol/L), direct bilirubin was 53·01 μmol/L (<11·97 μmol/L), and alkaline phosphatase was 400 U/L (<120 U/L). CT of his abdomen showed a hypodense lesion in the liver and intrahepatic ductal dilatation, suggestive of malignant disease. There was also a mantle of soft tissue anterior to the aorta (figure A). Endoscopic retrograde cholangiopancreatography showed an ulcerated, stenotic papilla, with no evidence of malignant disease. His symptoms and hyperbilirubinaemia improved following a papillotomy." @default.
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- W2146972933 date "2009-04-01" @default.
- W2146972933 modified "2023-09-23" @default.
- W2146972933 title "Painless jaundice with serial multi-organ dysfunction" @default.
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- W2146972933 doi "https://doi.org/10.1016/s0140-6736(09)60615-2" @default.
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