We report a case of distal common bile duct @entity652 presenting with acute @entity255 . A 47-year-old @entity1 suffered from right upper @entity490 with persistent @entity221 for 4 days. Abdominal ultrasonography showed mild dilatation of common bile duct and bilateral intrahepatic ducts. Endoscopic retrograde cholangiopancreatography disclosed a fixed filling defect in the distal common bile duct. Transpapillary biopsy and brush cytology was performed after sphincterotomy. The biopsy specimen showed @entity1412 with @entity1141 and negative stain for @entity876 . No significant regional lymph node enlargement was found on computed tomography. The @entity1 subsequently received exploratory laparotomy and sphincteroplasty with excision of the distal common @entity1126 . Finally, the @entity5 was diagnosed as common bile duct tubular @entity652 with moderate @entity10307 . Postoperatively, the @entity1 had an uneventful course and has been well at follow-up for 8 months. We encountered a rare case of common bile duct @entity652 in which malignant change was hard to rule out. We propose that sphincterotomy with biopsy is crucial before operation and @entity876 immunohistochemical staining is valuable for determining whether or not malignant change occurs in this borderline @entity5 .

Acute XXXX secondary to a common bile duct @entity652 .

@entity1 :: ('9606', 'Species') :: ['woman', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity1412 :: ('MESH:D011125', 'Disease') :: ['adenomatous change'] @entity1126 :: ('MESH:D001650', 'Disease') :: ['bile duct tumor'] @entity876 :: ('7157', 'Gene') :: ['p53'] @entity10307 :: ('MESH:C564596', 'Disease') :: ['nuclear dysplasia'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenoma'] @entity221 :: ('MESH:D005334', 'Disease') :: ['fever'] @entity255 :: ('MESH:D002761', 'Disease') :: ['cholangitis'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia']
@entity255 :: (MESH:D002761,Disease) :: ['cholangitis']
