Outcome of patients with ischemic-like cholangiopathy with secondary sclerosing cholangitis after liver transplantation

“…It is characterized by progressive increase in cholestatic biomarkers or recurrent bacterial cholangitis with a propensity to develop into liver failure over the course of several months [13–16]. Well known in the field of liver transplantation [17], ischemic cholangitis can be caused by any interference of blood flow to the peribiliary plexus including vascular injury during surgery, chemoembolization, low-flow states, or hypercoagulable conditions [11, 18, 19]. Recently it has been described in critically ill intensive care unit patients on high-pressure mechanical ventilation and vasopressor therapy [14].…”

Section: Discussionmentioning

confidence: 99%

Forsaken Foregut: Case Report of Simultaneous Black Esophagus and Ischemic Cholangiopathy

Cameron

Schweiger

2017

Case Reports in Medicine

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Black esophagus or acute esophageal necrosis rarely occurs after severe hemodynamic compromise or low-flow states. Other contributing factors may include corrosive injury from gastric contents and diminished mucosal repair mechanisms. Ischemic cholangitis, another rare clinical entity, is also usually the result of a significant vascular and/or hypotensive insult to the biliary tree. We describe the first case of combined acute esophageal necrosis and ischemic cholangiopathy in a 62-year-old male who completely recovered from the esophageal injury but developed progressive liver failure from ischemic cholangiopathy.

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“…SSC-CI remains a rare progression of jaundice and cholestasis in critically ill patients with fewer than 100 reported cases worldwide, mostly from Germany, and at least five with critical illness secondary to H1N1 influenza 2 3 5 6. There is no association with underlying hepatobiliary disease.…”

Section: Discussionmentioning

confidence: 99%

Rare case of severe cholangiopathy following critical illness

et al. 2014

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Secondary sclerosing cholangitis is a rare condition caused by disorders directly damaging the biliary tree. We present a case of a 34-year-old man with no pre-existing hepatobiliary disease who developed significant cholestasis and subsequent cholangitis while in the intensive care unit for multiorgan failure secondary to H1N1 influenza A (swine flu). After discharge from the intensive care unit, jaundice, fevers, abdominal pain, pruritus and ongoing cholestasis persisted, consistent with recurrent cholangitis. Secondary sclerosing cholangitis was confirmed by liver biopsy and endoscopic retrograde cholangiopancreatography. This is a case of the recently described syndrome of secondary sclerosing cholangitis following critical illness, with associated severe hypoxic and ischaemic injury. He subsequently developed recognised complications of sclerosing cholangitis, including fat-soluble vitamin deficiencies, recurrent cholangitis and liver fibrosis. To the best of our knowledge, this is the first reported case of secondary sclerosing cholangitis following critical illness in the UK.

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Outcome of patients with ischemic-like cholangiopathy with secondary sclerosing cholangitis after liver transplantation

Abstract: SC-CIP develops rapidly within several months. Enterococcus and C. albicans were the main isolated microorganisms in the bile. Sepsis was the main cause of death after LT. Overall, SC-CIP is a good indication for LT in selected patients.

Cited by 49 publications

References 13 publications

Secondary Sclerosing Cholangitis in Critically Ill Patients

Secondary Sclerosing Cholangitis in Critically Ill Patients

Forsaken Foregut: Case Report of Simultaneous Black Esophagus and Ischemic Cholangiopathy

Rare case of severe cholangiopathy following critical illness

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