title: Acute recurrent pancreatitis secondary to hepatocellular carcinoma invading the biliary tree.
abstract: Hepatocellular carcinoma rarely invades the biliary tree. Clots or tumor embolus passing though the bile duct can cause pancreatitis by a mechanism similar to gallstone pancreatitis. We present the case of a patient with recurrent acute pancreatitis, initially suspicious of biliary origin. Despite cholecystectomy he had new episodes of acute pancreatitis. Hepatocellular carcinoma was diagnosed after the third episode. ERCP findings suggested the presence of a fistula connecting the tumor and the biliary tree. The patient was operated and the hepatocellular carcinoma was resected. Its pathological analysis confirmed the communication between the tumor and the biliary duct.
authors: Departments of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain. Electronic address: fboladoc@cfnavarra.es.
authors: Federico
authors: F
authors: Bolado
authors: Hepato-biliary-pancreatic Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors: Antonio
authors: A
authors: Tarifa
authors: Hepato-biliary-pancreatic Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors: Cruz
authors: C
authors: Zazpe
authors: Departments of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors: Jose Maria
authors: JM
authors: Urman
authors: Hepato-biliary-pancreatic Surgery, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors: Javier
authors: J
authors: Herrera
authors: Departments of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors: Juan Jose
authors: JJ
authors: Vila
mesh_terms: D000208:Acute Disease; D001659:Biliary Tract / Q000473:pathology*; D001660:Biliary Tract Diseases / Q000473:pathology* / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology* / Q000473:pathology* / Q000601:surgery
keywords: Carcinoma; Common bile duct neoplasms; HBV and HIV coinfection; Hepatocellular; Pancreatitis; Tumor embolism