Abstract:Recurrent pyogenic cholangitis (RPC) is a clinical syndrome characterized by repeated episodes of suppurative cholangitis due to hepatolithiasis and extrahepatic stones in the biliary ducts. It is now recognized as a distinct syndrome with a different natural history and pathoetiology than spontaneously occurring liver abscesses. Most commonly seen in East Asian populations, this syndrome is growing increasingly common in Western Nations due to migration patterns. The exact pathogenesis of RPC remains elusive;… Show more
“…RPC is one of the few etiologies of SSC which is associated with CCA, occurring in up to 6% of patients, which may be a mucinous subtype [ 25 – 28 ]. ERCP or percutaneous techniques are often employed for intraductal stone extraction and management of underlying strictures, with partial hepatectomy reserved for advanced or refractory disease [ 29 ]. Fig.…”
Sclerosing cholangitis is a chronic cholestatic disease characterized by stricturing, beading, and obliterative fibrosis of the bile ducts. Sclerosing cholangitis is considered primary (PSC) if no underlying etiology is identified or secondary (SSC) if related to another identifiable cause. In this article, we will review the clinical features, pathogenesis, diagnosis, and imaging findings of PSC and SSC, with an emphasis on features that may aid in the distinction of these entities. We will also discuss various etiologies of SSC including recurrent pyogenic cholangitis, other infectious etiologies, ischemic damage, toxic insults, and immunologic, congenital, and miscellaneous causes, highlighting the unique imaging findings and clinical context of each diagnosis.
Graphical abstract
“…RPC is one of the few etiologies of SSC which is associated with CCA, occurring in up to 6% of patients, which may be a mucinous subtype [ 25 – 28 ]. ERCP or percutaneous techniques are often employed for intraductal stone extraction and management of underlying strictures, with partial hepatectomy reserved for advanced or refractory disease [ 29 ]. Fig.…”
Sclerosing cholangitis is a chronic cholestatic disease characterized by stricturing, beading, and obliterative fibrosis of the bile ducts. Sclerosing cholangitis is considered primary (PSC) if no underlying etiology is identified or secondary (SSC) if related to another identifiable cause. In this article, we will review the clinical features, pathogenesis, diagnosis, and imaging findings of PSC and SSC, with an emphasis on features that may aid in the distinction of these entities. We will also discuss various etiologies of SSC including recurrent pyogenic cholangitis, other infectious etiologies, ischemic damage, toxic insults, and immunologic, congenital, and miscellaneous causes, highlighting the unique imaging findings and clinical context of each diagnosis.
Graphical abstract
“… 1 Direct per-oral cholangioscopy provides excellent visualization of the intrahepatic ducts and has been used to assist in the removal of biliary stones. 2 , 3 , 4 …”
“…There are three review articles and one research paper in this issue: a promising new pharmacologic approach to preventing delirium in the ICU in geriatric patients ( 1 ); apixalban for reducing risk of DVT in knee and hip replacement surgery ( 2 ); the management of pyogenic cholangitis with ERCP ( 3 ) and organizing and prioritizing symptoms of patients presenting with Ebola viral disease ( 4 ).…”
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