Complicated diagnostics of primary sclerosing cholangitis in a patient with recurrent episodes of acute bacterial cholangitis
Abstract
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 dia-gnostic and therapeutic method of choice an urgent endoscopic retrograde cholangiopancreatography with a decompression of the biliary tree and subsequent targeted antibio-tic therapy. The dia-gnosis of primary sclerosing cholangitis can sometimes be difficult, as it was in our case, due to insufficient histologic verification and intercurrent clinical complications.