<![CDATA[Acute cholangitis in patients with Klatskin tumor Tumor Klatskin merupakan suatu kolangiokarsinoma tipe ekstrahepatik yang bersifat ganas dan timbul dari epitel duktus koledokus dan kedua percabangannya. Seorang wanita usia 47 tahun mengalami keluhan badan panas sejak 1 hari sebelum masuk rumah sakit. Satu hari sebelum masuk rumah sakit, pasien mengalami demam tinggi terus- menerus, tidak disertai dengan menggigil. Keluhan disertai nyeri hebat di perut kanan atas sampai ke ulu hati, nafsu makan menurun, mual setiap hendak makan, BAK berwarna seperti teh, BAB biasa, dan mata terlihat kuning. Satu minggu sebelum masuk rumah sakit, keluhan nyeri perut makin sering timbul disertai demam, mual, kadang-kadang muntah bila makan, dan nafsu makan makin turun. Hasil MRI menunjukkan kesan lesi hipointens dengan tepi yang irreguler di distal CBD sepanjang ±2 cm dengan dilatasi sedang CBD di bagian proksimalnya dan dilatasi ringan IHBD serta tak tampak dilatasi pada duktus pankreatikus, mengesankan massa di distal CBD yang menyebabkan obstruksi, curiga Klatskin Tumor Type 1 (berdasarkan Bismuth Classification). Pasien menolak dilakukan tindakan pembedahan maupun kemoterapi. Pasien mengaku merasa dalam kondisi baik, keluhan nyeri perut sangat jarang, nafsu makan sudah meningkat. Klatskin tumor is an malignant extrahepatic type of cholangiocarcinoma and arises from the choledocus ducte pithelium and its two branches. A 47-year-oldwoman has afever since one day before being hospitalized. One day before being admitted to the hospital, the patient experienced a persistent high fever, not accompanied by shivering. Complaints accompanied by severe pain in the right upper abdomen to the epigastrium, decreasedappetite, nausea, urine coloredliketea, normal bowelmovements, and eyes look yellow. One week before being hospitalized, complaintsof abdominal pain often came with fever, nausea, sometimes vomiting when eating, and appetite decreased. The MRI results showed hypointense lesions with irregular edges in the distal CBD of ±2 cm with moderate CBD dilatation in the proximal part and mild IHBD dilatation and no visible dilatation of the pancreatic ducts, impressive distal CBD mass causing obstruction, suspicious of Klatskin Tumor Type 1 (basedonBismuthClassification). Patient refused surgeryor chemotherapy. Patient claimed to feel in good condition, complaints of abdominal pain was veryrare, appetite has increased. ]]>
