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Primary sclerosing cholangitis and painless pancreatitis

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

MODY-type diabetes. Elevated liver and pancreatic enzymes. No history of abdominal pain.

Patient Data

Age: 70 years
Gender: Male

Segmental dilatation of bile ducts in the right liver lobe (mainly segment VIII). Interestingly, there is also periportal hyperperfusion in the early arterial phase after contrast. Necrotic pancreatitis of the tail with 2 pseudocysts and old splenic vein thrombosis. Collateral circulation via the gastric veins.

Case Discussion

This combination of findings may suggest autoimmune disease.

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