[Prolonged clinical remission of cholangitis in early human immunodeficiency virus infection after surgical biliary derivation].
During the acquired immunodeficiency syndrome, most cases of cholangitis develop at an advanced stage of disease. We report a case of cholangitis in a 47-year-old homosexual man, stage IIa according to Center of Disease Control classification. An isolated jaundice was the first manifestation of the disease. The number of CD4 was 380/microL. Ultrasonography and endoscopic retrograde cholangiography showed a 7 cm stenosis of the common bile duct, and cystic duct stenosis, with associated intra-hepatic biliary duct dilatation. No infectious agent was found. Cholecystectomy and hepaticojejunostomy were performed. Pathological examination of liver biopsy and a sample of the resected common bile duct was consistent with sclerosing cholangitis. The postoperative course was uneventful. During a three year follow-up period, the patient was disease free but he suddenly died of uncontrolled bleeding from duodenal ulcer. In HIV-infected patients, surgical treatment can be performed in case of symptomatic long stenosis of the common bile duct.
Di Martino
V
V
Unité de Gastroentérologie, Centre Hospitalier Intercommunal, Poissy.
Vitte
R L
RL
Eugène
C
C
Chamiot-Prieur
C
C
Bergue
A
A
Oberlin
P
P
D001662:Biliary Tract Surgical Procedures; D015209:Cholangitis, Sclerosing / Q000209:etiology / Q000601:surgery*; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors