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Abstract: Portal biliopathy is due to compression of the common bile duct by varicose veins constituting portal cavernoma. Usually asymptomatic, it can occasionally be responsible for jaundice or cholangitis. We report a case of portal cavernoma secondary to pylephlebitis complicating acute appendicitis, followed eleven years later by occurrence of cholestatic jaundice. Diagnosis of portal biliopathy was done by imaging and confirmed by endoscopic retrograde cholangiography with insertion of a plastic stent into common bile duct. This stent was periodically changed and allowed regression of jaundice with a 3-year follow-up. Through a review of the literature, both clinical and therapeutic characteristics of portal biliopathy were studied. [Copyright &y& Elsevier]

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Portal biliopathy is due to compression of the common bile duct by varicose veins constituting portal cavernoma. Usually asymptomatic, it can occasionally be responsible for jaundice or cholangitis. We report a case of portal cavernoma secondary to pylephlebitis complicating acute appendicitis, followed eleven years later by occurrence of cholestatic jaundice. Diagnosis of portal biliopathy was done by imaging and confirmed by endoscopic retrograde cholangiography with insertion of a plastic stent into common bile duct. This stent was periodically changed and allowed regression of jaundice with a 3-year follow-up. Through a review of the literature, both clinical and therapeutic characteristics of portal biliopathy were studied.

A benign villous tumor of the second duodenum was treated by endoscopic excision. Fifty-four previously published cases are reviewed. Villous tumors of the duodenum are very uncommon. Presenting features include intestinal bleeding and/or occlusive symptoms and/or obstructive jaundice. Diagnosis is established by fiberoptic endoscopy and biopsies. Complete removal of the tumor is mandatory because of the high incidence of malignant changes (approximately 33%). Endoscopic excision is only possible in a small number of cases, when the tumor is small, benign, and pedunculated. Complete removal of the tumor ald unequivocal diagnosis of benign tumor on histological examination are required to withstand from further therapy. The best procedure is often surgical excision or segmentary duodenal resection. This is satisfactory for benign lesions or tumors with focal in situ malignant changes. Pancreatoduodenectomy should be considered for invasive malignant tumors.