Dermatofibrosarcoma Protuberans Prognosis

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       Cancer - a life threatening disease. It is an autoimmune disease, where some of the body cell grow out of body's control and spread throughout the body. These abnormal body cells start destruction of normal body cell.       Cancer is due to some genetic changes in DNA structure of body. The normal body cells have a life span , but when there are such type of changes in DNA, these body cells do not die, rather they grow up and disturb the function of normally working cells.       There are some common cancers such as Lung cancer, skin cancer, breast cancer, colorectal cancer, bladder cancer, etc. There are some rare cancers also, that do not occur in general, and they may have no spreading speed as these common cancers have.  Dermatofibrosarcoma protuberans, is one of the rare type sarcoma.        Dermatofibrosarcoma protuberans (DFSP) is generally a flesh colored or reddish purplish colored firm patch of skin. It occurs generally in the middle layer of skin. From there, it c
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Dilated Common Bile Duct !!

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CBD

    Common bile duct(CBD) is a small duct in gastrointestinal system. It is a tube that joins common hepatic duct to the duct coming from gallbladder. The main function of CBD is to carry bile from gallbladder and empty it in the Duodenum ( the part of intestine between stomach and small intestine).

     Bile -
     Bile is collected in the gallbladder and secreted when it is required for digestion of fats from food. This bile is greenish yellow colour fluid, and is produced by liver. It contains cholesterol, bile salts and waste products after metabolism, such as bilirubin.

    Gall Stone - 
    Usually when the cholesterol metabolism is affected due to some liver functioning disordered, the saturation of the crystals of cholesterols increase in bile. This super saturation then becomes difficult to get dissolve and on the other hand there is hypersecretion of cholesterol due to disturbed functioning of liver. 
    Now, in gallbladder, some glycoprotein try to balance this disbalance of cholesterol, called mucin. This mucin is secreted by biliary epithelium. This results in hypo-mobility of  muscular wall of gallbladder, further delayed in emptying the gallbladder. 
    This stagnant bile flow cause accumulation of bile and formation of stones. Choledocolithiasis is the condition whenthis gall stone gets stuck in this CBD. 

    Cause Of Dilatation of CBD - 
   The most common cause of dilated common bile duct is gallbladder stones, inflammation of pancreas, or chronic pancreatitis, periampullary diverticulum, in some cases of cholecystectomy, inflammation of bile duct, tumor of bile duct or pancreas, or some surgical injury, etc.
    Blockage can be due to any of above causes, or due to biliary cancer. People with lower immune system may have to face this dilatation of duct.    

    Dilated common bile duct -
    When the bile duct is more than 7 mm in diameter, it is said as dilated CBD. This increase size of bile duct may suggest, any of the cause above mentioned. Generally, when patient undergoes for ultrasound sonography for some suspected liver or gallbladder disease, this can be seen in the images.

    Signs & Symptoms -
  • The main symptom observed is abdominal pain in right upper region of abdomen. 
  • The obstructed , dilated duct may cause the liver products secreted by liver, to go back to liver causing liver damage.
  • This backflow may enter the bloodstream.
  • Digestive juice that are delivered through bile duct can not reach to stomach and may cause digestive problems.
  • This obstruction may disturb the fat metabolism and may stop body from absorbing some fats, vitamins specially fat soluble vitamins, from food.
  • Nausea and vomiting are marked symptoms.
  • Yellow skin due to obstructive Jaundice.
  • Itching can be observed.
  • Loss of appetite.
    Diagnostic tests -
    Following observation can be helpful for confirm diagnosis -
  • Increased bilirubin and alkaline phosphatase level
  • Liver enzymes are higher than usual
    Some investigation can be advised such as -
  • Abdominal ultrasound sonography 
  • Abdominal CT scan
  • ERCP (Endoscopic-retrograde-cholangiopancreatography), etc.
    Treatment -
    The Obstruction if any should be removed, such as gallstones. Inflammation can be treated with proper medications. Some of the Homoeopathic medicines give good results for bile duct inflammation, or dilated common bile duct. 



Dr. Nilam
MD Homoeopathy
Mobile No. 9960205821

   
General Physician, Professor, HOD Community Medicine @P. Homoeopathic Medical College Khamgaon

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