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Case Reports
. 2021 Jul;74(1):519-521.
doi: 10.1002/hep.31650. Epub 2021 May 28.

Ketamine-Induced Sclerosing Cholangitis (KISC) in a Critically Ill Patient With COVID-19

Sally A I Knooihuizen  1   2 , Ariel Aday  1   2 , William M Lee  1   2
Affiliations
Case Reports

Ketamine-Induced Sclerosing Cholangitis (KISC) in a Critically Ill Patient With COVID-19

Sally A I Knooihuizen et al. Hepatology. 2021 Jul.
No abstract available

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Figures

FIG. 1
FIG. 1
Graphic illustration of the rise and fall in Alk P in relation to ketamine administration. Solid red line indicates intravenous (IV) ketamine infusion, dashed red line indicates oral ketamine administration, and red arrow indicates the date of a ketamine IV bolus.
FIG. 2
FIG. 2
MR cholangiopancreatography and liver biopsy findings demonstrating sclerosing cholangitis. (A) MR cholangiopancreatography findings of KISC as noted by blue arrow highlighting intrahepatic biliary dilatation with a beaded appearance and red arrow pointing to a dilated common bile duct with distal narrowing. (B) Liver biopsy showing one small portal tract with mild bile duct injury/reactive changes, ductular proliferation, and one adjacent small lobular non‐necrotizing granuloma (HE, ×100). (C) Liver biopsy showing a portal tract with bile duct injury and minimal infiltration of neutrophils in the portal tract and lobule without marked cholestasis (HE, 40×).
See this image and copyright information in PMC

References

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    1. Turkish A, Luo JJ, Lefkowitch JH. Ketamine abuse, biliary tract disease, and secondary sclerosing cholangitis. Hepatology 2013;58:825‐827. - PubMed
    1. Lo RSC, Krishnamoorthy R, Freeman JG, Austin AS. Cholestasis and biliary dilatation associated with chronic ketamine abuse: a case series. Singapore Med J 2011;52:52‐55. - PubMed
    1. Ruemmele P, Hofstaedter F, Gelbmann CM. Secondary sclerosing cholangitis. Nat Rev Gastroenterol Hepatol 2009;6:287‐295. - PubMed

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