November 12, 2014
Notes: Petrushenko, V V
Sukhodolia, S A
Falalieieva, T M
Berehova, T V
Klin Khir. 2013 Dec;(12):69-72.
Reference Type: Journal Article
Record Number: 4748Author: Piccolboni, P., Ragone, E., Inzirillo, A. and Utili, R.
Title: Primary sclerosing cholangitis in patient with celiac disease complicated by cholecystic empyema and acute pancreatitis
Journal: G Chir
Short Title: Primary sclerosing cholangitis in patient with celiac disease complicated by cholecystic empyema and acute pancreatitis
Alternate Journal: Il Giornale di chirurgia
ISSN: 0391-9005 (Print)
Accession Number: 24629813
Keywords: Acute Disease
Cholagogues and Choleretics/therapeutic use
Cholangiopancreatography, Endoscopic Retrograde
Esophageal and Gastric Varices/etiology/surgery
Jaundice, Obstructive/drug therapy/etiology
Ursodeoxycholic Acid/therapeutic use
Abstract: BACKGROUND: The association of celiac disease and sclerosing cholangitis is a well known, although unusual, pathologic feature of autoimmunity. METHODS: A 64 year old patient presenting with sub-acute cholangitis and pancreatitis, treated with cholecystectomy and endoscopic sphincterotomy. The post-operative course, complicated by cholestatic jaundice, and subsequent clinical complications are described, showing how the diagnosis of sclerosing cholangitis was outlined after the Endoscopic Retrograde Cholangio-Pancreatography (ERCP) and confirmed by liver biopsy. Long term treatment with Ursodeoxycholic acid has gradually normalized bilirubin values, while cholestasis enzymes are gradually decreasing. After 18 months bleeding from oesophageal varices ensued, which was controlled through endoscopic ligation. CONCLUSIONS: The diagnosis of primary sclerosing cholangitis should be taken into account when cholangitis is associated with other immunity derangements and segmentary dilatations of the intra-hepatic bile ducts, but no dilatation of the main bile duct is noticed at imaging or endoscopy. Recovery of hepatic function should be always attempted before bringing the patient to surgery, in order to avoid postoperative hepatic decompensation.