Portal hypertension may be present, resulting in other conditions including enlarged spleen, hematemesis, and melena. These problems can severely affect the patients quality of life. In a 10-year period between 1995 and 2005, only 10 patients were surgically treated for Caroli disease, with an average patient age of 45.8 years.After reviewing 46 cases of Caroli disease before 1990,  21.7% of the cases were the result of an intrahepatic cyst or nonobstructive biliary tree dilation, 34.7% were linked with congenital hepatic fibrosis, 13% were isolated choledochal cystic dilation, and the remaining 24.6% had a combination of all three. Causes
The cause appears to be genetic; the simple form is an autosomal dominant trait, while the complex form is an autosomal recessive trait. Females are more prone to Caroli disease than males. Family history may include kidney and liver disease due to the link between Caroli disease and ARPKD. PKHD1, the gene linked to ARPKD, has been found mutated in patients with Caroli syndrome. PKHD1 is expressed primarily in the kidneys with lower levels in the liver, pancreas, and lungs, a pattern consistent with phenotype of the disease, which primarily affects the liver and kidneys. The genetic basis for the difference between Caroli disease and Caroli syndrome has not been defined. Diagnosis
Modern imaging techniques allow the diagnosis to be made more easily and without invasive imaging of the biliary tree. Commonly, the disease is limited to the left lobe of the liver.
Stannic oxide (SnO2)
The primary uses for stannic oxide (SnO2) include polishing glass, marble, silver, and jewelry in addition to creating dyes for fabrics, paper, ceramic glazes, printing inks, coatings, and pigments in food polymers. Stannic oxide is also insoluble in water and dissociates in sulfuric acids and hydrochloric acid. Case studies
De-tinning plant
In 1679, a 26 year old tin miner who worked in a smelter was found to have odd lung physiology after a radiography. He was asymptomatic despite having profuse small, metallic nodules in the lungs. At the same plant, a 55 year old man who loaded scrap tin into smelting furnaces for 15 years was assessed. His radiography confirmed that his cough and crackle was due to metallic bilateral nodules on the lungs, or stannosis. The second males biopsy revealed macrophages overwhelmed with dust deposits that affected hist connective tissue in the lungs. The case study determined that two workers in a detinning mine, who handled molten tin, developed stannosis. According to the researchers of "Stannosis: A report of 2 cases", the two workers were subject to the dustiest job of packaging tin-oxide for transportation. Tin miners are typically researched when assessing for stannosis because their exposure to tin oxides is around 70-80% in comparison to other job tasks in a plant. Tinning milk reservoir tanks
After 17 years of painting tin hot tin powder into the inside of tanks, a 74 year old male patient developed a dry cough and progressive dyspnea.