Clinical masks or manifestations of the biliary sample: diagnosis, choice of rational pharmacotherapy

Abstract

Clinical masks or variants  of a course  of biliary pathology  are analyzed  in the  article. The knowledge  of these  masks (course variants) is very important because it expands  our view of pathology, considerably  reduces  process  of diagnostics and narrows range  of nosologies  between which differential  diagnostics should  be carried out. Brief description of the  most frequent  variants – masks, which form biliary pathology, is presented in the article. Among them the following variants are indicated: 1) cutaneous; 2) cardiac; 3) oesophageal; 4) autonomic  dysfunction;  5) pancreatic;  6) dyspeptic; and 7) colitis-like variant. Each variant has a clinical sign that allows it to be classified as biliary pathology. Due to the large number of mask variants, a unified examination programme  and diagnostic  steps, a probable  diagnosis wording is given, allowing the most rational therapy to be chosen. Clinical trial included  120 patients:  10 pregnant women with cholestasis (a small but very important study, as pregnant women are often encountered in therapeutic practice, and they are often subjected to unnecessary investigations, resulting  in lost time, and therapy requires  markedly more effort), 45 with organic pathology  and 65 with problems  of functional  nosologies. The pharmacotherapy included a highly effective artichoke drug, which has a pathogenetic effect on most of the pharmacological targets and has a choleretic and protective  effect. Overall treatment efficacy was 90% with good tolerability  and no side effects.