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MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY UNCOVERING A RARE BILE DUCT STENOSIS LEADING TO HEPATIC ENCEPHALOPATHY: A CASE REPORT Setyawan, Gratia Enggar; Dermoredjo, Sutaryanu
International Journal of Radiology and Imaging Vol. 5 No. 01 (2026): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.ijri.2026.005.01.05

Abstract

Common bile duct (CBD) biliary stricture is an uncommon but clinically significant cause of chronic cholestasis and hepatic dysfunction that may progress to hepatic encephalopathy (HE). Identification of biliary obstruction as the reversible etiology of HE is crucial for appropriate management. Magnetic Resonance Cholangiopancreatography (MRCP) is a non-invasive imaging modality with high diagnostic accuracy for evaluating biliary pathology without contrast administration or ionizing radiation. We report a 47-year-old woman presenting with recurrent confusion, progressive jaundice, and significant weight loss, with a history of previous biliary surgery. MRCP demonstrated marked dilatation of the common bile duct and absence of choledocholithiasis, consistent with postoperative CBD biliary stricture. The patient developed recurrent hepatic encephalopathy secondary to chronic cholestasis and hepatic dysfunction. Surgical revision of the bilodigestive shunt resulted in clinical stabilization and improvement. This case highlights the essential role of MRCP in identifying biliary stricture as a treatable cause of hepatic encephalopathy and guiding definitive surgical management.
Asymmetric Spinal Cord Compression by Intradural Extramedullary Tumor at Thoracic Level: A Case Report Gavrila, Priska Gian; Dermoredjo, Sutaryanu
Acta Neurologica Indonesia Vol. 4 No. 01 (2026): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

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Abstract

Background: Spinal tumors are a rare type of tumor, accounting for approximately 15% of all tumors in the central nervous system. Most cases occur in individuals of working age. Symptoms may include localized pain or radiating pain to the extremities, and in some cases, severe motor deficits. Back pain tends to develop gradually, is independent of activity, and may worsen when lying down. CT scans, MRI, histopathological, and immunohistochemical examinations assist in establishing the diagnosis. The primary management of spinal tumors is surgical intervention, with the surgical approach varying depending on the type of tumor. Objective: To report the case of a 44-year-old female patient with a spinal tumor treated at Bethesda Hospital Yogyakarta. Case Description: A 44-year-old female presented with complaints of back pain lasting one month and bilateral lower extremity edema. In 2014, the patient experienced a fall in the bathroom resulting in loss of consciousness, and she undergoes spinal surgery in 2022. A non-contrast MRI revealed an intradural extramedullary mass at the level of thoracic vertebrae T2–T3, located on the left posterolateral aspect. Histopathological examination showed tumor tissue consistent with meningothelial and psammomatous meningioma, with a differential diagnosis of schwannoma. The patient undergoes a laminectomy as definitive management. Conclusion: Spinal tumors often present with pain and may result in severe motor deficits. Diagnosis is supported by imaging studies, histopathology, and immunohistochemistry to guide appropriate management.