Ganglio-Biliary Syndrome is caused by the enlargement of hilar lymph nodes compressing the common bile duct. Since 1980, there have been a few reports of this condition in China, which is also known as Derincentis Syndrome. The lymphatic tissue of the hepatic pedicle connects with the mesenteric lymphatic system, and mesenteric lymphadenitis is often accompanied by hilar lymphadenitis. Therefore, the Ganglio-Biliary Syndrome may be the same disease as mesenteric lymphadenitis.

bubble_chart Pathogenesis

The mechanism of disease may involve persistent enlargement of the pre-biliary lymph nodes, which compress the common bile duct and lead to clinical symptoms.

bubble_chart Clinical Manifestations

It manifests as recurrent episodes of paroxysmal pain in the upper abdomen, sometimes accompanied by nausea, vomiting, fear of cold, fever, and jaundice. Signs include obvious tenderness, rebound tenderness, and muscle tension under the xiphoid process and in the right upper abdomen, a positive Murphy's sign, and a possible palpable mass in the gallbladder area, resembling the presentation of acute cholecystitis.

bubble_chart Diagnosis

The clinical diagnosis of this syndrome is quite challenging. If there are frequent and intense biliary colicky pains along with varying degrees of obstructive jaundice, this syndrome should be considered. It is difficult to differentiate from acute cholecystitis and cholelithiasis, and even B-ultrasound examinations may not easily distinguish them. A definitive diagnosis often requires exploratory laparotomy.

bubble_chart Treatment Measures

After diagnosis, the enlarged lymph nodes need to be removed, but the gallbladder does not need to be excised if there are no complications such as cholecystitis or gallstones.