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Related Experiment Videos

Extremely elevated CA19-9 in acute cholangitis.

Shyr-Ming Sheen-Chen1, Cheuk-Kwan Sun, Yei-Wei Liu

  • 1Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan. smsheen@yahoo.com

Digestive Diseases and Sciences
|April 4, 2007
PubMed
Summary

A common bile duct stone caused significant jaundice and elevated cancer antigen 19-9 (CA19-9) levels. Successful stone removal normalized CA19-9, highlighting its role as a marker for biliary obstruction.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Surgical Oncology

Background:

  • Elevated cancer antigen 19-9 (CA19-9) can indicate biliary obstruction or malignancy.
  • Jaundice and epigastric pain are common symptoms of biliary tract disease.

Observation:

  • A 68-year-old female presented with epigastric pain radiating to the back, jaundice, fever, and chills.
  • Laboratory results revealed elevated liver enzymes, direct bilirubin, and a markedly high CA19-9 level (5673.8 U/ml).
  • Imaging showed a dilated common hepatic duct and diffuse biliary tree dilatation with a distal common bile duct obstruction.

Findings:

  • Surgical exploration identified and successfully removed a black stone from the distal common bile duct.
  • Post-operatively, the patient's CA19-9 levels decreased significantly, returning to normal within one month.

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Implications:

  • This case underscores the importance of considering benign biliary obstruction in the differential diagnosis of significantly elevated CA19-9.
  • Prompt diagnosis and management of common bile duct stones are crucial for resolving obstructive jaundice and normalizing tumor markers.
  • CA19-9 can serve as a valuable biomarker for monitoring treatment response in patients with biliary obstruction.