KAROLIJEVA BOLEST – BOLEST O KOJOJ SE MALO RAZMIŠLJA: PRIKAZ BOLESNIKA
Sažetak
Karolijeva bolest je retko oboljenje, koje karakteriše dilatacija velikih intrahepatičnih žučnih kanala. Javlja se u retkoj izolovanoj formi, koju odlikuju ponovljene epizode holangitisa i periportalna fibroza (tip I). Znatno češća varijanta povezana je sa kongenitalnom fibrozom jetre (tip II). Iako se bolest može javiti tokom čitavog života, najčešće se javlja pre tridesete godine. Incidencija i prevalencija ove bolesti nisu poznate, ali je procena da se javlja jednom u 10.000 do 20.000 slučajeva. Glavni simptomi su povišena telesna temperatura, bol ispod desnog rebarnog luka, napadi žutice, svrab po koži, mučnina i povraćanje. Dijagnostika se vrši kliničkim pregledom, ultrazvučnim pregledom, kompjuterizovanom tomografijom abdomena, a u cilju definitivne dijagnostike primenjuju se endoskopska retrogradna holangiopankreatografija i biopsija jetre. U slučaju razvoja ciroze jetre i portne hipertenzije radi se proksimalna endoskopija. Prikazujemo klinički slučaj čoveka starijeg životnog doba, koji nekoliko godina unazad boluje od Karolijeve bolesti. Prikazani su dijagnostički izazovi i primenjena terapija.
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