SECONDARY SCLEROSING CHOLANGITIS

Secondary sclerosing cholangitis leads to slow and often irreversible destruction of the walls of both intra- and extrahepatic bile ducts. A s for primary sclerosing cholangitis, clinical signs and laboratory fi ndings reveal cholestasis. The diagnosis is confirmed by retrograde en doscopic cholangiography which shows narrowed bile ducts and rarefied ramifications of the intra-hepatic ductal system. Several causes have been identified including infectious causes with or without a relation ship to bile duct obstruction and human immunodeficiency virus infecti on as well as ischaemic related causes after chemotherapy, arterial em bolization or Liver transplantation. Other causes include chemical agr ession after treatment for hydatic cysts and post-surgical complicatio ns due to a damaged bile tract. Treatment is difficult and often depen dent on the cause.