CAROLI’S DISEASE

Caroli's Disease

Definition

Caroli's disease is a rare congenital disorder characterized by non-obstructive dilatation of the intrahepatic bile ducts.

Types

Caroli's disease is classified into three types:

1. Type I: solitary dilatation of a single intrahepatic bile duct
2. Type II: multiple dilatations of intrahepatic bile ducts
3. Type III: Caroli's disease with associated congenital anomalies of the biliary system

Causes

The exact cause of Caroli's disease is unknown; however, it is believed to be a congenital anomaly resulting from abnormal development of the intrahepatic bile ducts.

Clinical Features

The clinical features of Caroli's disease may include:

• Abdominal pain
• Jaundice
• Fever
• Cholangitis
• Biliary cirrhosis
• Ascites

Investigations

The diagnosis of Caroli's disease is confirmed by:

• Imaging studies: ultrasound, CT scan, MRI
• Cholangiography: endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC)
• Biopsy: liver biopsy may be performed to rule out other conditions

Complications

The complications of Caroli's disease may include:

• Cholangitis
• Biliary cirrhosis
• Ascites
• Liver failure
• Malignancy (rarely)

Management

The management of Caroli's disease depends on the severity of the disease and may include:

• Conservative management: supportive care, antibiotics, and analgesics
• Surgical management: resection of the affected bile ducts, liver transplantation
• Endoscopic management: balloon dilatation, stenting, or sphincterotomy

Treatment

The treatment of Caroli's disease aims to:

• Relieve symptoms
• Prevent complications
• Improve liver function
• Improve quality of life

Surgical Steps

The surgical steps for Caroli's disease may include: 1 → Resection of the affected bile ducts 2 → Liver transplantation 3 → Endoscopic balloon dilatation 4 → Stenting or sphincterotomy

Homoeopathic Therapeutic Medicines

The following homoeopathic medicines may be used in the treatment of Caroli's disease:

• Calcarea carbonica: for liver enlargement and jaundice
• Lycopodium clavatum: for liver and biliary tract problems
• Graphites: for liver and gallbladder problems
• Chelidonium majus: for liver and bile duct problems