Curbside Consultation of the Pancreas: 49 Clinical Questions

Scott Tenner, MD, MPH; Alphonso Brown, MD, MS Clin Epi; Frank Gress, MD

Question 42: I Have A Patient With Suspected Primary Sclerosing Cholangitis. What Do I Need To Know And How Do I Establish The Diagnosis? (continued)

Ronald Concha-Parra, MD; Frank G. Gress, MD

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by inflammation, fibrosing, and destruction of the intrahepatic and/or extrahepatic biliary ducts. This disease can affect large as well as small bile ducts. Cholangiography is useful only in the detection of abnormalities of the large intrahepatic and extrahepatic bile ducts. Disease limited to the small intrahepatic ducts is diagnosed by liver biopsy. The typical course of PSC is characterized by insidious worsening of cholestasis, advancing to portal hypertension, cirrhosis, end-stage liver disease…