Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 298.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 298.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26656347
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2015 ; 94
(49
): e2188
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Secondary Sclerosing Cholangitis in Critically Ill Patients: Clinical
Presentation, Cholangiographic Features, Natural History, and Outcome: A Series
of 16 Cases
#MMPMID26656347
Leonhardt S
; Veltzke-Schlieker W
; Adler A
; Schott E
; Eurich D
; Faber W
; Neuhaus P
; Seehofer D
Medicine (Baltimore)
2015[Dec]; 94
(49
): e2188
PMID26656347
show ga
Secondary sclerosing cholangitis in critically ill patients (SSC-CIP) is an
important differential diagnosis in patients presenting with cholestasis and
PSC-like cholangiographic changes in endoscopic retrograde cholangiography (ERC).
As a relatively newly described entity, SSC-CIP is still underdiagnosed, and the
diagnosis is often delayed. The present study aims to improve the early detection
of SSC-CIP and the identification of its complications.A total of 2633 records of
patients who underwent or were listed for orthotopic liver transplantation at the
University Hospital Charité, Berlin, were analyzed retrospectively. The clinical
presentation and outcome (mean follow-up 62.7 months) of the 16 identified
SSC-CIP cases were reviewed.Cholestasis was the first sign of SSC-CIP. GGT was
the predominant enzyme of cholestasis. Hypercholesterolemia occurred in at least
75% of the patients. SSC-CIP provoked a profound weight loss (mean 18?kg) in 94%
of our patients. SSC-CIP was diagnosed by ERC in all patients. The 3 different
cholangiographic features detected correspond roughly to the following stages:
(I) evidence of biliary casts, (II) progressive destruction of intrahepatic bile
ducts, and (III) picture of pruned tree. Biliary cast formation is a hallmark of
SSC-CIP and was seen in 87% of our cases. In 75% of the patients, the clinical
course was complicated by cholangiosepsis, cholangitic liver abscesses,
acalculous cholecystitis, or gallbladder perforation. SSC-CIP was associated with
worse prognosis; transplant-free survival was ?40 months (mean).Because of its
high rate of serious complications and unfavorable prognosis, it is imperative to
diagnose SSC-CIP early and to differentiate SSC-CIP from other types of
sclerosing cholangitis. Specific characteristics enable identification of
SSC-CIP. Early cooperation with a transplant center and special attention to
biliary complications are required after diagnosis of SSC-CIP.