Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Gastroenterology


Answer 2
  1. PSC. PSC is a cholestatic liver disease that results in chronic inflammation, fibrosis, and structuring of the intra- and extrahepatic biliary tree. It can ultimately lead to cirrhosis and hepatic failure in some patients. PSC is frequently seen in patients with inflammatory bowel disease (ulcerative colitis and Crohn’s disease). Figure 1 shows diffuse bilateral intrahepatic strictures and loss of high intrahepatic ducts (pruning). These strictures cause episodes of cholangitis with fever. In PBC, the cholangiogram is usually normal. Choledocholithiasis would show stones in the common bile duct (CBD) on ERCP, which are absent in this case. SSC often presents as diffuse intra- and extrahepatic stone disease or develops following a bile duct injury, causing a biliary stricture. A patient with hepatitis A would likely have a normal cholangiogram.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/31/08 • kkj