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[Chronic abdominal pain in elderly patient].
Silvio Trepp1,2, Lukas Zimmerli1
1Kantonsspital Olten, Olten.
Praxis
|April 23, 2026
Summary
Caroli syndrome, a rare cystic liver disease, was diagnosed in an elderly kidney transplant patient presenting with symptoms of acute pyelonephritis. This diagnosis highlighted the importance of considering rare liver conditions in complex patient histories.
Area of Science:
- Hepatology
- Gastroenterology
- Medical Diagnostics
Background:
- A 75-year-old female with autosomal-dominant polycystic kidney disease and a history of kidney transplantation presented with urinary tract infection symptoms.
- The patient's symptoms masked underlying chronic abdominal pain and elevated bilirubin levels.
- Magnetic resonance cholangiopancreatography (MRCP) revealed significant liver abnormalities.
Purpose of the Study:
- To report a rare case of Caroli syndrome diagnosed in an elderly patient with a complex medical history.
- To emphasize the diagnostic challenges posed by overlapping symptoms of liver and kidney diseases.
- To highlight the utility of MRCP in diagnosing cystic liver diseases.
Main Methods:
- Clinical case presentation.
- Review of patient's medical history and symptoms.
- Diagnostic imaging using MRCP.
Main Results:
- Diagnosis of Caroli syndrome, characterized by cystic liver disease and fibrosis, was confirmed.
- The patient's acute pyelonephritis symptoms were found to be masking the chronic liver condition.
- Complete cystic transformation of the left liver lobe was observed.
Conclusions:
- Caroli syndrome can present atypically and be masked by other conditions, even in elderly patients.
- Prompt and thorough diagnostic evaluation, including advanced imaging, is crucial for identifying rare diseases.
- This case underscores the importance of a comprehensive approach to patient care, integrating findings from different organ systems.
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