SCLEROSING CHOLANGITIS AFTER BURN INJURY

We present the case of a 57-year-old woman who developed persistant ja undice and cholestasis four weeks after a severe burn injury (34% of t he body surface, 19% second degree, 15% third degree). In the endoscop ic retrograde cholangiography four months later the characteristic pic ture of sclerosing cholangitis was found. A causal relation between th e thermal injury and the development of sclerosing cholangitis is like ly because of this coincidence and the absence of any preexisting dise ase, especially of the hepatobiliary system. Other cholestatic liver d isease could be excluded. Possible pathogenetic mechanisms are discuss ed, especially the increased permeability of the gut mucosa after burn injuries with consecutive translocation of bacteria and toxins and th eir transport into the biliary tract.