Secondary sclerosing cholangitis

The secondary sclerosing cholangitis (SSC) is a disease of the intrahepatic bile ducts with sclerotic reconstruction, mostly as a result of obstruction of the bile ducts is formed. The cause is often unknown. Compared to primary sclerosing cholangitis (PSC), the course is more severe and progressive in some cases.

root cause

The cause is typically an obstruction in the draining biliary tract (such as a calculus). In rare cases, reduced blood flow in the biliary tract, the introduction of chemotherapeutic agents or congenital diseases ( e.g. polyarteritis nodosa ) can be the cause.

SSC has also been described for patients in the intensive care unit (without any identifiable causes). However, there are indications that an occlusion of the biliary tract is also likely, since the biliary tract is then filled with a viscous fluid.

Diagnosis

Typically, the liver values are greatly increased . ERCP is suitable for making a diagnosis , showing stenotic narrowing of the biliary tract. The formation of a so-called cast is characteristic histologically . This is a cast of the biliary tract through protein deposits .

therapy

A causal therapy is currently not possible. A cure can only be achieved through a liver transplant . Medicinal improvement through ursodeoxycholic acid, as in primary sclerosing cholangitis, is hardly apparent. However, there is evidence that budesonide can relieve symptoms .

Individual evidence

1. ↑ CM Gelbmann et al.: Secondary sclerosing cholangitis in intensive care patients. In: The gastroenterologist. Jan 2008, 3 1, pp. 45-50, Springer Verlag, (online) .
2. ↑ Prim. Prof. Dr. Ludwig Kramer 1st Medical Department with Gastroenterology Hospital Hietzing with Neurological Center Rosenhügel Vienna.

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