20 / 25
6
t h
A n n u a l E u r o p e a n C o n f e r e n c e o n
Gastroenterology
Euro Gastro 2018
J u n e 1 9 - 2 0 , 2 0 1 8
P a r i s , F r a n c e
Page 46
Journal of Clinical Gastroenterology and Hepatology
ISSN 2575-7733
Introduction:
Fungal organisms can be found in biliary cultures of patients on
prolonged antibiotics treatment and have stents; however, fungal masses, or
“balls”, are rarely encountered and extremely difficult to eradicate. The aim
of this study is to share our experience in fungal cholangitis complicating
malignant bile duct obstruction and to review reports previously published that
are concerned with management of the recurrent obstruction secondary to
candida infections and its correlation with biliary malignancies.
Methods:
We present our experience with 3 patients who complained of
obstructive jaundice. All patients had multiple episodes of fungal cholangitis.
Bile samples were obtained during percutaneous trans-hepatic cholangiogram
(PTC). Two patients were diagnosed with cholangiocarcinoma and one with
adenocarcinoma of the head of the pancreas.
Results:
Persistent biliary candidiasis may carry a higher morbidity when it
raises on the background of biliary malignancy, due to the prolonged course
of medical treatment and patient hospitalization, recurrent obstruction with
“fungus balls”, frequent needs to intervene with invasive procedures such as
Endoscopic Retrograde Cholangiopancreatography (ERCP) and PTC, and the
delay in initiation of chemotherapy.
Conclusion:
patients with positive fungal cultures of bile samples obtained
by PTC may have coincidental cancers; similasr to cholangiocarcinoma,
peri-ampullary tumors and gallbladder cancer, therefore, screening with
tumor markers, cytology samples and imaging studies is recommended.
Aggressive sensitivity-based treatment with systemic antifungals along with
external biliary drainage and irrigation with antifungals may be necessary for
eradication of infection.
Biography
Al Manasra is a medical graduate of Jordan University of
Science and Technology, Jordan. He was trained in General
Surgery at King Abdullah University Hospital and obtained
his higher specialization degree and the country boards in
General Surgery. In 2013, he was graduated from the Medical
University of South Carolina (MUSC), SC, USAwith an Advanced
Abdominal Multi-Organ Transplant and Hepatobiliary Surgery
fellowship. He also undertook another fellowship, at the MUSC,
in Pediatric Abdominal Transplant Surgery. In 2014, he has
been assigned his current position as an Assistant Professor
of Surgery, and a Consultant Transplant and Hepatobiliary
Surgeon at Jordan University of Science and Technology/King
Abdullah University Hospital.
abdjust@yahoo.comAbdel Rahman Al Manasra
Jordan University of Science and Technology, Jordan
Abdel Rahman Al Manasra et al., J Clin Gastroenterol Hepatol 2018, Volume: 2
DOI: 10.21767/2575-7733-C1-002
Biliary candidiasis as a sign of malignancy in patients with
obstructive jaundice