[Primary sclerosing cholangitis presenting as recurrent cholangitis and right hepatic duct outpouching].

Abstract

Primary sclerosing cholangitis (PSC) may have an atypical mode of presentation with recurrent cholangitis and diverticulum-like outpouchings of the hepatic ducts; a high clinical suspicion is required to confirm the diagnosis instead of ascribing cirrhosis to a secondary cause as a result of the biliary stasis propitiated by the biliary cysts. We describe the case of a 63-year old woman with a one-year history of episodes of cholangitis and a persistent elevation of alkaline phosphatase. The endoscopic retrograde cholangiopancreatography and a magnetic resonance cholangiography showed strictures of the intrahepatic biliary tract compatible with PSC and a diverticulum-like outpouching of the right hepatic duct. A liver biopsy revealed cirrhosis. Initial management consisted of antibiotics, a sphincterotomy and the placement of a biliary plastic stent, however, the patient continued to have recurrent cholangitis and finally, the cyst was resected.

• Authors: Carlos Moctezuma-Velázquez, Angela Saúl-Pérez, Eric López-Méndez
• Journal: Gaceta medica de Mexico (Gac Med Mex) 2012 Sep-Oct Vol. 148 Issue 5 Pg. 476-9 ISSN: 0016-3813 [Print] Mexico
• Vernacular Title: Quiste de la vía biliar y colangitis de repetición como manifestaciones iniciales de colangitis esclerosante primaria.
• PMID: 23128889 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Cholangitis (etiology)
• Cholangitis, Sclerosing (complications, diagnosis)
• Female
• Hepatic Duct, Common (pathology)
• Humans
• Middle Aged
• Recurrence