Radiological patterns of secondary sclerosing cholangitis in patients after lung transplantation

Kim, Hye Jin; Park, Mi‐Suk; Son, Jinwoo; Han, Kyunghwa; Lee, Jei Hee; Kim, Jai Keun; Paik, Hyo Chae

doi:10.1007/s00261-018-1819-2

Cited by 5 publications

(3 citation statements)

References 18 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of note, while periportal lymphadenopathy is a characteristic feature in PSC, it was not seen in our cases of COVID-19-associated SSC [ 29 , 30 ]. Ultimately, the imaging findings in our cohort of COVID-19-associated SSC do not differ from previously described imaging findings of SSC from other causes, hence, the clinical context is essential in the differential diagnosis [ 31 – 33 ].…”

Section: Discussionsupporting

confidence: 50%

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

et al. 2022

View full text Add to dashboard Cite

Background Despite emerging reports of secondary sclerosing cholangitis (SSC) in critically ill COVID-19 patients little is known about its imaging findings. It presents as delayed progressive cholestatic liver injury with risk of progression to cirrhosis. Diagnosis cannot be made based on clinical presentation and laboratory markers alone. Magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) can aid in the diagnosis. The aim of this study was to describe MRI/MRCP imaging features of COVID-19-associated SSC. Results Seventeen patients (mean age 60.5 years, 15 male) who underwent MRI/MRCP were included. All had been admitted to intensive care unit (ICU) (median duration of ICU stay 10 weeks, range, 2–28 weeks) and developed acute respiratory distress syndrome requiring mechanical ventilation. On imaging, all patients had intrahepatic bile duct strictures and 10 (58.8%) had associated upstream dilatation. Intrahepatic bile duct beading was seen in 14 cases (82.3%). Only one patient (5.9%) had extrahepatic bile duct stricturing. Patchy arterial phase hyperenhancement and high signal on T2- and diffusion-weighted images were seen in 7 cases (53.8%) and 9 cases (52.9%), respectively. Biliary casts were seen in 2 cases (11.8%). Periportal lymphadenopathy and vascular complications were not seen. Conclusion On MRI/MRCP, COVID-19-associated SSC presents with multiple intrahepatic bile duct strictures with or without upstream dilatation and intrahepatic bile duct beading. Surrounding hepatic parenchymal changes including alterations in enhancement and T2 signal are common. The extrahepatic biliary tree was typically spared and periportal lymphadenopathy was missing in all patients.

show abstract

Section: Discussionsupporting

confidence: 50%

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…SSC, as in our case, is usually diagnosed by imaging techniques such as ERCP and MRI. Distinguishing features include strictures and stenosis as well as newly developed dilations of intra- and extrahepatic bile ducts[ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report

Steiner¹,

Kaufmann-Bühler²,

Fuchsjäger³

et al. 2022

World J Gastrointest Surg

View full text Add to dashboard Cite

BACKGROUND With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019 in Wuhan, China, liver injury in patients with coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection has been regularly reported in the literature. There are a growing number of publications describing the occurrence of secondary sclerosing cholangitis (SSC) after SARS-CoV-2 infection in various cases. We present a case of sudden onset SSC in a critically ill patient (SSC-CIP) following COVID-19 infection who was previously healthy. CASE SUMMARY A 33-year old female patient was admitted to our University Hospital due to increasing shortness of breath. A prior rapid antigen test showed a positive result for SARS-CoV-2. The patient had no known preexisting conditions. With rapidly increasing severe hypoxemia she required endotracheal intubation and developed the need for veno-venous extracorporeal membrane oxygenation in a setting of acute respiratory distress syndrome. During the patient´s 154-d stay in the intensive care unit and other hospital wards she underwent hemodialysis and extended polypharmaceutical treatment. With increasing liver enzymes and the development of signs of cholangiopathy on magnetic resonance cholangiopancreatography (MRCP) as well as endoscopic retrograde cholangiopancreatography (ERCP), the clinical setting was suggestive of SSC. At an interdisciplinary meeting, the possibility of orthotopic liver transplantation and additional kidney transplantation was discussed due to the constant need for hemodialysis. Following a deterioration in her general health and impaired respiratory function with a reduced chance of successful surgery and rehabilitation, the plan for transplantation was discarded. The patient passed away due to multiorgan failure. CONCLUSION SSC-CIP seems to be a rare but serious complication in patients with SARS-CoV-2 infection, of which treating physicians should be aware. Imaging with MRCP and/or ERCP seems to be indicated and a valid method for early diagnosis. Further studies on the effects of early and late SSC in (post-) COVID-19 patients needs to be performed.

show abstract

“…As ischemic or CMV colitis, colorectal ulcer, and PTLD can cause hematochezia or melena, a prompt evaluation is necessary [ 91 ]. Gastric ulcer perforation and hyperbilirubinemia due to secondary sclerosing cholangitis were reported in South Korean studies [ 95 - 97 ].…”

Section: Gastrointestinal Complicationsmentioning

confidence: 99%

Medical Complications of Lung Transplantation

Park

2022

J Chest Surg

View full text Add to dashboard Cite

Lung transplantation (LT) is now considered as an effective treatment option for end-stage lung diseases that improves the short and long-term survival rates and quality of life. As increasingly many LT procedures are being performed, the medical complications of LT are also increasing in frequency and emerging as a very important issue for transplant clinicians. Although chronic lung allograft dysfunction and infection are major causes of death after LT, many medical complications, several of which result from immunosuppressive treatment, contribute to increased mortality and morbidity. This article reviews the most frequent and important medical complications of LT, accompanied by a review of the literature and studies from South Korea, including lung allograft rejection, infection, and non-allograft organ systemic complications.

show abstract

Radiological patterns of secondary sclerosing cholangitis in patients after lung transplantation

Cited by 5 publications

References 18 publications

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report

Medical Complications of Lung Transplantation

Contact Info

Product

Resources

About