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Case Reports
. 2021 Dec:80:239-242.
doi: 10.1016/j.clinimag.2021.07.017. Epub 2021 Jul 27.

A case of secondary sclerosing cholangitis due to COVID-19

Shima Tafreshi  1 , Ian Whiteside  2 , Irving Levine  3 , Catherine D'Agostino  4
Affiliations
Case Reports

A case of secondary sclerosing cholangitis due to COVID-19

Shima Tafreshi et al. Clin Imaging. 2021 Dec.

Abstract

COVID-19 was first recognized by the World Health Organization (WHO) in December 2019 and declared a global pandemic in March 2020. Although COVID-19 primarily results in pulmonary symptoms, it is becoming apparent that it can lead to multisystemic manifestations. Liver damage with elevated AST and ALT is seen in patients with COVID-19. Although the etiology of liver damage is still debated, biliary damage is rarely seen. This case demonstrates a potential complication of COVID-19 in a previously healthy patient. The patient contracted COVID-19 in March 2020 and endured a complicated course including intubation, multiple readmissions, and chronic abdominal pain. He is now awaiting a liver transplant. Our case portrays biliary damage as an additional possible complication of COVID-19 and the importance of imaging in its diagnosis.

Keywords: COVID-19; Cholangiopathy; Hepatobiliary; Secondary sclerosing cholangitis.

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Figures

Fig. 1
Fig. 1
Baseline coronal (A) unenhanced CT images showing normal caliber common bile duct (arrow).
Fig. 2
Fig. 2
(A) Coronal contrast-enhanced CT showing common bile duct dilatation to 8 mm with hyperenhancing wall. (B) Axial contrast-enhanced CT showing intrahepatic biliary ductal dilatation (arrowheads) and periportal edema (arrows).
Fig. 3
Fig. 3
(A) MRCP image showing diffuse intrahepatic ductal beading and irregularity of the common bile duct (arrow). (B) Axial contrast-enhanced fat-saturated T1 image showing intrahepatic ductal beading (arrow).
Fig. 4
Fig. 4
(A) Grayscale ultrasound image showing irregularity of the intrahepatic bile ducts. (B) Color Doppler ultrasound image showing markedly thickened common bile duct wall (arrow) with small-caliber lumen (arrowhead).
Fig. 5
Fig. 5
ERCP image showing tortuous and attenuated intrahepatic bile ducts (arrows) with nondilated extrahepatic ducts.
See this image and copyright information in PMC

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