[Combined cholestatic jaundice due to cholelithiasis and primary biliary cirrhosis]

Abstract

An 82-year-old man was admitted because of painless jaundice and pruritus. Multiple small gallstones were seen on ultrasonography. Hepatic needle biopsy revealed bile stasis, intrahepatic bile ducts proliferation and inflammatory infiltration of the portal spaces. As the jaundice deepened, cholecystectomy was performed and a gallbladder full of small calculi was removed. Wedge biopsy of the liver led to the diagnosis of primary biliary cirrhosis (PBC). Colchicine was started and since then his condition has improved and become stable. PBC in an old man is very uncommon. The combination with gallbladder stones imposed special diagnostic and therapeutic problems. Although gallbladder stones are more common in PBC than in the general population, the combination of the 2 clinical entities is not sufficiently emphasized in the literature.