Primary sclerosing cholangitis

Case contributed by Dr Ali Abougazia

Presentation

Recurrent abdominal pain and jaundice.

Patient Data

Age: 52
Gender: Male
Modality: MRI

Dilated CBD with beaded appearance of the intra-hepatic biliary radicles with irregular dilatations and strictures as well as numerous variable sized intra-ductal calculi (hepatolisthiasis) being of high T1GRE and low T2 GRE signals.

Complementary CT and ultrasonographic examination showed these calculi to be heavily calcified.

CT Abdomen

Modality: CT

Dilated CBD and intra-hepatic biliary radicles with calcified hepatolisthiasis.

Liver ultrasound

Modality: Ultrasound

Intra-ductal calculi (hepatolisthiasis) with posterior acoustic shadowing.

Dilated CBD.

Case Discussion

The described picture is that of primary sclerosing cholangitis.

The main differential diagnosis in this case is oriental cholangiohepatitis. However, the patient is not asian and there is no history of parasitic infestation, thus the diagnosis of oriental cholangiohepatitis is unlikely.

PlayAdd to Share

Case Information

rID: 27066
Case created: 19th Jan 2014
Last edited: 19th Mar 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.