Journal of Clinical Gastroenterology and Hepatology Open Access

Biliary candidiasis as a sign of malignancy in patients with obstructive jaundice

6^th Annual European Conference on Gastroenterology

June 19-20, 2018 Paris, France

Abdel Rahman Al Manasra

Jordan University of Science and Technology, Jordan

Scientific Tracks Abstracts: J Clin Gastroenterol Hepatol

Abstract:

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, USA with 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.

E-mail: abdjust@yahoo.com