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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2013-3-2-129-133</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-974</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Практика</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Practice</subject></subj-group></article-categories><title-group><article-title>Трудности диагностики опухоли Клатскина у пациента, страдающего циррозом печени</article-title><trans-title-group xml:lang="en"><trans-title>Challenges of the Klatskin tumor diagnosis in a patient suffering from cirrhosis of the liver</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маев</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Mayev</surname><given-names>I. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пенкина</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Penkina</surname><given-names>T. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Андреев</surname><given-names>Д. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Andreyev</surname><given-names>D. N.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дичева</surname><given-names>Д. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Dicheva</surname><given-names>D. T.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Субботина</surname><given-names>Ю. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Subbotina</surname><given-names>Yu. S.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБОУ ВПО МГМСУ им. А.И. Евдокимова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>RAMS</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФКУЗ «Главный клинический госпиталь МВД России», Москва</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Main Clinical Hospital of the Ministry of the Interior of Russia, Moscow</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБОУ ВПО МГМСУ им. А.И. Евдокимова Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>MSUMD named after A.I. Evdokimov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>30</day><month>12</month><year>2013</year></pub-date><volume>0</volume><issue>3-2</issue><fpage>129</fpage><lpage>133</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маев И.В., Пенкина Т.В., Андреев Д.Н., Дичева Д.Т., Субботина Ю.С., 2013</copyright-statement><copyright-year>2013</copyright-year><copyright-holder xml:lang="ru">Маев И.В., Пенкина Т.В., Андреев Д.Н., Дичева Д.Т., Субботина Ю.С.</copyright-holder><copyright-holder xml:lang="en">Mayev I.V., Penkina T.V., Andreyev D.N., Dicheva D.T., Subbotina Y.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/974">https://www.med-sovet.pro/jour/article/view/974</self-uri><abstract><p>Представленный клинический пример иллюстрирует этапы диагностического поиска у пациента, поступившего в стационар с выраженными проявлениями холестатического синдрома. В силу наличия у пациента цирроза печени алиментарного генеза и отсутствия желчнокаменной болезни холестаз рассматривался в рамках основного заболевания. Однако прогрессирующая на фоне адекватного лечения желтуха, ухудшение общего состояния пациента заставили расширить круг диагностического поиска. Неоднозначность результатов лучевых методов диагностики явилась существенным препятствием на пути выявления опухоли Клатскина.</p></abstract><trans-abstract xml:lang="en"><p>The clinical example demonstrates several stages of diagnostic search in patients admitted to hospital with severe manifestations of cholestatic syndrome. Due to the presence of alimentary liver cirrhosis and absence of cholelithiasis, cholestasis was evaluated with regard to the underlying disease. However, progressive jaundice against a background of adequate treatment and deterioration of the general condition of the patient forced the doctors to extend the range of diagnostic search. Heterogeneity of results of diagnostic imaging was the major obstacle to the detection of Klatskin tumor.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>холангиокарцинома</kwd><kwd>опухоль Клатскина</kwd><kwd>цирроз печени</kwd><kwd>алкогольный гепатит</kwd><kwd>желтуха</kwd><kwd>холестаз</kwd><kwd>диагностика</kwd><kwd>cholangiocarcinoma</kwd><kwd>Klatskin tumor</kwd><kwd>liver cirrhosis</kwd><kwd>alcoholic hepatitis</kwd><kwd>jaundice</kwd><kwd>cholestasis</kwd><kwd>diagnosis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kuang D., Wang G. Hilar cholangiocarcinoma: Pathology and tumor biology. Front. Med. China. 2010. №4. P. 371-377.</mixed-citation><mixed-citation xml:lang="en">Kuang D., Wang G. Hilar cholangiocarcinoma: Pathology and tumor biology. Front. Med. China. 2010. №4. 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