Bacterial cholangitis causing secondary sclerosing cholangitis: a case report.
BACKGROUND
Although bacterial cholangitis is frequently mentioned as a cause of secondary sclerosing cholangitis, it appears to be extremely rare, with only one documented case ever reported.


METHODS
A 48-year-old woman presented with an episode of acute biliary pancreatitis that was complicated by pancreatic abcess formation. After 3 months she had an episode of severe pyogenic (E. Coli) cholangitis that recurred over the subsequent 7 months on a further two occasions. Initially, cholangiography suggested the presence of extra-biliary intrahepatic abcesses while repeated investigations demonstrated development of multiple segmental biliary duct strictures. After maintenance antibiotic treatment was started, no episodes of cholangitis occurred over a 14-month period.


CONCLUSIONS
Sclerosing cholangitis can rapidly develop after an episode of bacterial cholangitis. Extra-biliary involvement of the hepatic parenchyma with abcess formation may be a risk factor for developing this rare but particularly severe complication.
ter Borg
Pieter C J
PC
Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands. terborg@mdl.azr.nl
van Buuren
Henk R
HR
Depla
Annekatrien C T M
AC
D018784:Abdominal Abscess / Q000150:complications*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000150:complications* / Q000382:microbiology; D015209:Cholangitis, Sclerosing / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D004927:Escherichia coli Infections / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications*