Primary sclerosing cholangitis in patient with celiac disease complicated by cholecystic empyema and acute pancreatitis

Piccolboni, P. and Ragone, E. and Inzirillo, A. and Utili, R. (2013) Primary sclerosing cholangitis in patient with celiac disease complicated by cholecystic empyema and acute pancreatitis. Il giornale di chirurgia, 34 (9/10). pp. 267-270. ISSN 1971-145X

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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.

Item Type:	Article
Additional Information:	Sclerosing cholangitis, Celiac disease, Cholecystitis, Pancreatitis
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	13 Sep 2019 08:44
Last Modified:	13 Sep 2019 08:44
URI:	http://eprints.bice.rm.cnr.it/id/eprint/8642

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