Journal article
Biliary tract calculi in primary sclerosing cholangitis
The American journal of gastroenterology, Vol.90(1), pp.72-75
1995
DOI: 10.1111/j.1572-0241.1995.tb08013.x
PMID: 7801953
Abstract
By conventional criteria the diagnosis of primary sclerosing cholangitis (PSC) is excluded if biliary tract calculi are present.
Objective: To compare patients with sclerosing cholangitis with and without calculi.
Methods: Retrospective review between 8/91 and 9/93 identified 63 patients with sclerosing cholangitis alone (Group A) and 22 patients with sclerosing cholangitis and biliary tract calculi (Group B). The mean follow-up was 13.6 months. Clinical features reviewed were age, sex, associated inflammatory disease (IBD), and clinical presentation. Cholangiographic features compared were site and extent of disease. Endoscopic stone extraction was reviewed for success and complications.
Results: Both groups had the following features in common: 1) mean age (45.9 vs 46.3 yr), 2) prevalence of IBD (68.3 vs 72.7%), 3) extent of bile duct strictures (intrahepatic: 28.5% vs 27.2%; extrahepatic: 12.7% vs 13.6%; both: 58.7% vs 54.5%). There were proportionately more women in Group B (45.5% vs 33.3%). Symptomatic presentation (pain, pruritus, jaundice, and cholangitis) was seen more often in Group B: 86.4% compared with Group A: 39.7% (specifically cholangitis was seen in 22.7% vs 4.7%). Among Group B, calculi developed subsequent (mean 40.2 months) after the diagnosis of sclerosing cholangitis in 77.3% of patients. The distribution of calculi was cholelithiasis: 7 (31.8%); choledocholithiasis: 9 (40.9%); and both: 6 (27.2%). Of the patients with choledocholithiasis alone, 78% had undergone previous cholecystectomy. Endoscopic stone extraction was successful in 13 (86.6%) of the patients with choledocholithiasis. Complications included mild pancreatitis in one patient and bleeding from sphincterotomy site in another patient which responded to sclerotherapy. In follow-up, only one patient had recurrent calculi and underwent successful stone extraction.
Conclusion: We suggest that biliary tract calculi are a part of the spectrum of otherwise typical PSC and therefore their presence should not necessarily exclude the diagnosis.
Details
- Title: Subtitle
- Biliary tract calculi in primary sclerosing cholangitis
- Creators
- MADHUKAR KAW - Univ. Pittsburgh school medicine, div. gastroenterology hepatology, Pittsburgh PA, United StatesW. B SILVERMAN - Univ. Pittsburgh school medicine, div. gastroenterology hepatology, Pittsburgh PA, United StatesM RABINOVITZ - Univ. Pittsburgh school medicine, div. gastroenterology hepatology, Pittsburgh PA, United StatesR. R SCHADE - Univ. Pittsburgh school medicine, div. gastroenterology hepatology, Pittsburgh PA, United States
- Resource Type
- Journal article
- Publication Details
- The American journal of gastroenterology, Vol.90(1), pp.72-75
- Publisher
- Blackwell Publishing
- DOI
- 10.1111/j.1572-0241.1995.tb08013.x
- PMID
- 7801953
- ISSN
- 0002-9270
- eISSN
- 1572-0241
- Language
- English
- Date published
- 1995
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094604602771
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