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Complicated diagnostics of primary sclerosing cholangitis in a patient with recurrent episodes of acute bacterial cholangitis


Authors: L. Douda 1;  R. Keil 1;  J. Lochmannová 1;  J. Drábek 1;  O. Fabián 2;  L. Hornofová 2;  E. Honsová 3;  M. Jirsa⁴
Authors‘ workplace: Interní klinika 2. LF UK a FN v Motole, Praha 1;  Ústav patologie a molekulární medicíny, 2. LF UK a FN v Motole, Praha 2;  Pracoviště klinické a transplantační patologie, Transplacentrum, IKEM, Praha 3;  Centrum experimentální medicíny, IKEM, Praha 4
Published in: Gastroent Hepatol 2015; 69(4): 368-375
Category: Clinical and Experimental Gastroenterology: Case Report
doi: https://doi.org/10.14735/amgh2015368

Overview

Acute bacterial cholangitis is one of the possible complications of primary sclerosing cholangitis and in some cases it can occur as a fulminant cholangiogenic sepsis with septic shock and multiple organ dysfunction syndrome. The authors describe a case of a 39-year‑ old man where the primary sclerosing cholangitis manifested as recurrent episodes of acute bacterial cholangitis, including one with a life‑ threatening consequences. The dia­gnostic and therapeutic method of choice an urgent endoscopic retrograde cholangiopancreatography with a decompression of the biliary tree and subsequent targeted antibio­tic therapy. The dia­gnosis of primary sclerosing cholangitis can sometimes be difficult, as it was in our case, due to insufficient histologic verification and intercurrent clinical complications.

Key words:
primary sclerosing cholangitis –  acute bacterial cholangitis –  cholangiogenic sepsis –  endoscopic retrograde cholangiography

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for bio­­­medical papers.

Submitted:
12. 8. 2014

 Accepted:
11. 1. 2015


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