EDITOR'S QUIZ: GI SNAPSHOT

Jaundice in a chronic hepatitis B carrier

R Noun¹, S Zeidan², C Ghorra³, S Slaba⁴, L Menassa-Moussa⁵, R Sayegh⁶

¹ Saint Joseph University of Beirut, Department of Digestive Surgery, Hotel Dieu de France Hospital, Beirut, Lebanon
² Department of Digestive Surgery, Hotel Dieu de France Hospital, Beirut, Lebanon
³ Department of Pathology, Hotel Dieu de France Hospital, Beirut, Lebanon
⁴ Saint Joseph University of Beirut, Department of Radiology, Hotel Dieu de France Hospital, Beirut, Lebanon
⁵ Department of Radiology, Hotel Dieu de France Hospital, Beirut, Lebanon
⁶ Saint Joseph University of Beirut, Department of Gastroenterology, Hotel Dieu de France Hospital, Beirut, Lebanon

Correspondence to:
Correspondence to:
Dr S Zeidan
Department of Digestive Surgery, Hotel Dieu de France Hospital, Alfred Naccache Street, Achrafieh, PO Box 166830, Beirut, Lebanon; smart_zeidan@yahoo.com

The first 150 words of the full text of this article appear below.

A 50-year-old man presented with a 4-week history of jaundice that developed progressively. He had chronic hepatitis B. During the last 3 months, he had complained of repetitive bouts of right upper abdominal pain with fever. Clinical examination was normal except for jaundice. Biological tests revealed a normal complete blood count and abnormal liver tests with cholestatic and cytolytic features (-glutamyl transpeptidase = 850 IU/l (normal<43 IU/l), alkaline phosphatase = 299 IU/l (normal<126), total bilirubin = 134 µm/l (normal<22), aspartate transaminase = 101 IU/l (normal<59), alanine transaminase = 116 IU/l (normal<72). The -fetoprotein level was normal and the CA 19-9 level was elevated at 139 IU/ml (normal<37 IU/ml). HBsAg and IgG anti-HBc were positive.

On abdominal ultrasonography, the intrahepatic bile ducts were dilated. No parenchymal tumour was detected and the gallbladder was unremarkable. Magnetic resonance cholangiopancreatography showed a homogeneous liver parenchyma and a filling defect of the hepatic duct . . . [Full text of this article]

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EDITOR’S QUIZ: GI SNAPSHOT
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