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Cholangiocarcinoma

 Syn. Bile duct cancer , CC , Cholangiocarcinoma of biliary tract

Signs & Symptoms

 Painless jaundice
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma] Cecil [ 474] Epocrates [ https://online.epocrates.com/diseases/72133/Cholangiocarcinoma/History-Exam]
Pruritus
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma] Epocrates [ https://online.epocrates.com/diseases/72131/Cholangiocarcinoma/Diagnostic-Approach]
Symptoms of obstructive jaundice
Ref: Epocrates [ https://online.epocrates.com/diseases/72131/Cholangiocarcinoma/Diagnostic-Approach]
Pale stool
Ref: Epocrates [ https://online.epocrates.com/diseases/72131/Cholangiocarcinoma/Diagnostic-Approach]

Physical Examination

 Painless jaundice
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma] Cecil [ 474] Epocrates [ https://online.epocrates.com/diseases/72133/Cholangiocarcinoma/History-Exam]
Jaundice
Note: Cholangiocarcinomas involving only the intrahepatic ducts are less likely to be jaundiced
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma] Harrison [ 280]
Intermittent jaundice
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma]

Lab / Serology

 Elevated 5 nucleotidase #biliary_obstruction
Note: confirm the hepatobiliary origin of the excess alkaline phosphatase
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma]
Elevated total bilirubin #biliary_obstruction
Note: often above 10 mg/dL
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma]
Elevated direct bilirubin #biliary_obstruction
Ref: Uptodate [ Clinical manifestations and diagnosis of cholangiocarcinoma]

Imagin Study

 Ascites
Ref: Uptodate [ Liver flukes: Clonorchiasis and opisthorchiasis]

Complication

Risk Factors

 Choledocholithiasis
Ref: Epocrates [ https://online.epocrates.com/diseases/72131/Cholangiocarcinoma/Diagnostic-Approach]
Alcoholic liver disease
Ref: Epocrates [ https://online.epocrates.com/diseases/72132/Cholangiocarcinoma/Risk-Factors]
Cholecystolithiasis
Ref: Epocrates [ https://online.epocrates.com/diseases/72131/Cholangiocarcinoma/Diagnostic-Approach]

Cause

Other