AIDS-RELATED CHOLANGIOPANCREATOGRAPHIC CHANGES

The cholangiographic and pancreatographic appearances of the acquired immunodeficiency syndrome (AIDS) associated cholangitis were evaluated in 26 patients. Twenty-four patients were diagnosed by retrograde cho langiography or endoscopic cholangiopancreatography (ERC or ERCP). One patient was diagnosed by T-tube cholangiography and another patient b y transhepatic cholangiography. The radiographic findings ranged from intrahepatic ductal abnormalities with or without involvement of the e xtrahepatic biliary tree (eight patients) to irregularities and strict ures involving the ampulla of Vater or the intrapancreatic portion of the common bile duct (CBD) with proximal dilatation (18 patients). Sig nificant strictures involving the juxta-ampullary pancreatic duct were identified in six of 12 patients. Twenty-one of the 26 patients had a ssociated infections which included: Cryptosporidium (CS), Mycobacteri um avium intracellulare (MAI), cytomegalovirus (CMV), Microsporidium ( MSP), and Isospora (ISP). Three patients were operated upon for acute acalculous cholecystitis. In each instance, organisms were identified in both the bile duct and the inflamed gall bladder.