Sclerosing cholangitis and liver cirrhosis after extrabiliary infections: Report on three cases

Objective: To describe three unusual cases of sclerosing cholangitis after severe extrahepatic/extrabiliary bacterial infections, Design. Case report, clinical. Setting: Tertiary care intensive care unit (ICU), Patients: Three patients admitted to the ICU with infections from Gram-posi tive bacteria followed by sclerosing cholangitis and secondary biliary cirr hosis, Main Results: Three unusual cases of persisting cholestasis that occurred a fter bacterial infections originating from extrahepatic/extrabiliary foci a re described. Endoscopic retrograde cholangiopancreatography and magnetic r esonance cholangiopancreatography revealed multiple strictures of the intra hepatic bile ducts as a sign of sclerosing cholangitis. All patients progre ssed to biliary cirrhosis within months after the onset of cholestasis, Conclusion: infection-associated cholestasis is usually a functional disord er and subsides after effective treatment of the underlying inflammatory fo cus. In rare cases, however, extrahepatic/extrabiliary infections may lead to sclerosing cholangitis and secondary biliary cirrhosis via unknown mecha nisms.