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Review
. 2002 Jun 3:2:14.
doi: 10.1186/1471-230x-2-14.

Bacterial cholangitis causing secondary sclerosing cholangitis: a case report

Pieter C J ter Borg  1 , Henk R van Buuren, Annekatrien C T M Depla
Affiliations
Review

Bacterial cholangitis causing secondary sclerosing cholangitis: a case report

Pieter C J ter Borg et al. BMC Gastroenterol. .

Abstract

Background: Although bacterial cholangitis is frequently mentioned as a cause of secondary sclerosing cholangitis, it appears to be extremely rare, with only one documented case ever reported.

Case presentation: A 48-year-old woman presented with an episode of acute biliary pancreatitis that was complicated by pancreatic abcess formation. After 3 months she had an episode of severe pyogenic (E. Coli) cholangitis that recurred over the subsequent 7 months on a further two occasions. Initially, cholangiography suggested the presence of extra-biliary intrahepatic abcesses while repeated investigations demonstrated development of multiple segmental biliary duct strictures. After maintenance antibiotic treatment was started, no episodes of cholangitis occurred over a 14-month period.

Conclusions: Sclerosing cholangitis can rapidly develop after an episode of bacterial cholangitis. Extra-biliary involvement of the hepatic parenchyma with abcess formation may be a risk factor for developing this rare but particularly severe complication.

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Figures

Figure 1
Figure 1
ERCP during the first episode of cholangitis This ERCP was performed during the first episode of cholangitis. There are multiple abcesses in connection with the biliary tree and several stones.
Figure 2
Figure 2
ERCP performed two weeks later This ERCP was performed two weeks after the first ERCP. The left and right hepatic ducts are narrowed.
Figure 3
Figure 3
ERCP after 10 months This ERCP was performed ten months after the first ERCP. Hilar biliary stenoses and multiple filliform strictures of segmental intrahepatic ducts, associated with peripheral bile duct dilatation are shown.
See this image and copyright information in PMC

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