case_images: PMC8502119_01
case_images: Ultrasonography of the abdomen revealed enlarged size of the liver with increased nodularity (blue arrow)
case_images: qmj-2021-045-g001.jpg
case_images: PMC8502119_01_qmj-2021-045-g001.jpg
case_images: fig1
case_images: Ultrasonography (USG) of the abdomen revealed an enlarged liver with increased nodularity (Figure 1).
case_images: Endoscopic image of gastric fundal varices (blue arrow)
case_images: qmj-2021-045-g002.jpg
case_images: PMC8502119_01_qmj-2021-045-g002.jpg
case_images: fig2
case_images: 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.
case_images: Hematoxylin and eosin-stained liver biopsy (A: 100 x , B: 400 x ): intrahepatic cholestasis with moderate fibrosis (blue arrow) and inflammatory cells (red arrow)
case_images: qmj-2021-045-g003.jpg
case_images: PMC8502119_01_qmj-2021-045-g003.jpg
case_images: fig3
case_images: 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.