Chapter 20, Kalangiocarsinoma

Colangio-Carsinoma is a type of cancer that originates in the bile ducts.

The majority are adenocarsinomas.

It may affect the bile ducts inside the liver, the intra-herpatic ducts, or the bile ducts outside the liver, the extra

hepatic ducts. The most common site is the perihila region, which is where the right

and the left hepatic duct have joined to become the common bile duct, just after they leave

the liver. The key risk factors for Kalangio-carcinoma to remember are primary sclerosing colangitis

and liver flukes, which are a parasitic infection.

A tom tip for you, patients with ulcerative colitis are at risk of developing primary sclerosing

colangitis.

Patients that have primary sclerosing colangitis are at risk of developing calangiocarcinoma,

about 10 to 20%.

When it comes to calangiocarcinoma, primary sclerosing colangitis is the key risk factor that's

worth remembering for your exams. The other notable cause is parasitic infection with liver

flukes, which are found in various parts of Southeast Asia and Europe. Let's talk about the

presentation. Obstructive jaundice is the key presenting feature to remember.

Obstructive jaundice is associated with pale stools, dark urine, and generalised itching.

Other nonspecific signs and symptoms of calangio carcinoma include unexplained weight loss, right-up

quadrant pain, a palpable gallbladder, which is swollen due to an obstruction in the duct

that's distal to the gall-to-the-goleadder, causing a back pressure of bile building up inside

the gallbladder, and finally, hepatomegaly.

Cuvoisier's law states that if there's a palpable gull bladder and the patient has jaundice,

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