PMC8502119_01
Ultrasonography of the abdomen revealed enlarged size of the liver with increased nodularity (blue arrow)
qmj-2021-045-g001.jpg
PMC8502119_01_qmj-2021-045-g001.jpg
fig1
Ultrasonography (USG) of the abdomen revealed an enlarged liver with increased nodularity (Figure 1).
Endoscopic image of gastric fundal varices (blue arrow)
qmj-2021-045-g002.jpg
PMC8502119_01_qmj-2021-045-g002.jpg
fig2
To evaluate the cause of melena, upper gastrointestinal endoscopy was performed under general anesthesia, which revealed gastric fundal varices (Figure 2), and four bands were applied.
Hematoxylin and eosin-stained liver biopsy (A: 100 x , B: 400 x ): intrahepatic cholestasis with moderate fibrosis (blue arrow) and inflammatory cells (red arrow)
qmj-2021-045-g003.jpg
PMC8502119_01_qmj-2021-045-g003.jpg
fig3
As the etiology of jaundice was still unclear, USG-guided liver biopsy was taken, which showed intrahepatic cholestasis with moderate fibrosis and inflammatory cells (Figure 3); hence, a preliminary diagnosis of progressive intrahepatic cholestasis (PFIC) was made.