Complicated diagnostics of primary sclerosing cholangitis in a patient with recurrent episodes of acute bacterial cholangitis
Authors:
L. Douda 1; R. Keil 1; J. Lochmannová 1; J. Drábek 1; O. Fabián 2; L. Hornofová 2; E. Honsová 3; M. Jirsa⁴
Authors place of work:
Interní klinika 2. LF UK a FN v Motole, Praha
1; Ústav patologie a molekulární medicíny, 2. LF UK a FN v Motole, Praha
2; Pracoviště klinické a transplantační patologie, Transplacentrum, IKEM, Praha
3; Centrum experimentální medicíny, IKEM, Praha
4
Published in the journal:
Gastroent Hepatol 2015; 69(4): 368-375
Category:
Clinical and Experimental Gastroenterology: Case Report
doi:
https://doi.org/10.14735/amgh2015368
Summary
Acute bacterial cholangitis is one of the possible complications of primary sclerosing cholangitis and in some cases it can occur as a fulminant cholangiogenic sepsis with septic shock and multiple organ dysfunction syndrome. The authors describe a case of a 39-year‑ old man where the primary sclerosing cholangitis manifested as recurrent episodes of acute bacterial cholangitis, including one with a life‑ threatening consequences. The diagnostic and therapeutic method of choice an urgent endoscopic retrograde cholangiopancreatography with a decompression of the biliary tree and subsequent targeted antibiotic therapy. The diagnosis of primary sclerosing cholangitis can sometimes be difficult, as it was in our case, due to insufficient histologic verification and intercurrent clinical complications.
Key words:
primary sclerosing cholangitis – acute bacterial cholangitis – cholangiogenic sepsis – endoscopic retrograde cholangiography
The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.
Submitted:
12. 8. 2014
Accepted:
11. 1. 2015
Zdroje
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