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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2015; 69(4): 368–377. doi:10.14735/amgh2015368.

Complicated diagnostics of primary sclerosing cholangitis in a patient with recurrent episodes of acute bacterial cholangitis

Ladislav Douda Orcid.org  1, Radan Keil Orcid.org  1, Jindra Lochmannová Orcid.org  2, Jiří Drábek Orcid.org  2, Ondřej Fabián3, Ludmila Hornofová3, Eva Honsová Orcid.org  4, Milan Jirsa Orcid.org  5

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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.

Keywords

acute bacterial cholangitis, cholangiogenic sepsis, primary sclerosing cholangitis

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