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Gastroenterology

Expert perspectives on IBD, liver disease, motility disorders, and GI diagnostic and therapeutic procedures.

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How do you manage patients with suspected cholangiocarcinoma that presents with biliary obstruction but has repeated negative brushings/biopsies?

2 Answers

Mednet Member

Medical Oncology · Mayo Clinic, Rochester

This is often encountered in patients with PSC. Patients present with jaundice and biliary stricture, rising CA 19-9, and repeat ERCP with brushing/biopsies have shown no evidence of malignancy (often showed abnormal cells). Brushings have high specificity if positive (99%) but very poor sensitivity...

How do you approach an obese patient on long-term methotrexate with normal liver tests in terms of workup for underlying fatty liver?

1 Answers

Mednet Member

Rheumatology · Mainehealth

Screen with ultrasound.

Gastroenterology

Recent Discussions

How do you manage patients with suspected cholangiocarcinoma that presents with biliary obstruction but has repeated negative brushings/biopsies?

How do you approach an obese patient on long-term methotrexate with normal liver tests in terms of workup for underlying fatty liver?

Sunanda V. Kane, MD

Stephen B. Hanauer, MD

Ali Rezaie, MD, MS

Eamonn M. Quigley, MD

Ashwin N. Ananthakrishnan, MD

Mihir Patel

Feenalie Patel

Vasilios Kalas