Primary sclerosing cholangitis

Case contributed by Mohammad Taghi Niknejad
Diagnosis almost certain


Abdominal pain and jaundice.

Patient Data

Age: 30 years
Gender: Female

Mild dilatation of intrahepatic and extrahepatic bile ducts are seen, and CBD measured 15 mm in caliber. Mild wall thickening is also evident, particularly at distal CBD. Gallbladder is over distended.

A little free fluid is seen in the pelvis.

Diffuse irregularity with a beaded appearance is noted at intrahepatic bile ducts.
There are a few stenotic segments at the central intrahepatic and extrahepatic bile ducts.

Case Discussion

Features are most consistent with early-stage primary sclerosing cholangitis, an uncommon inflammatory condition, which affects the biliary tree resulting in multiple strictures, liver damage, and eventually cirrhosis.

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