title: An unusual presentation of primary sclerosing cholangitis.
abstract: This case report describes the unusual presentation of a patient who had findings which were initially suggestive of a type IV choledochal cyst. Her liver biopsy demonstrated biliary cirrhosis. She was treated with endoscopic retrograde cholangiopancreatography and biliary stent exchanges over one year. Her cholangiogram one year later demonstrated resolution of the biliary cystic dilation which led to her initial diagnosis, with beading and stricturing of the hepatic ducts consistent with primary sclerosing cholangitis. Liver-associated enzymes and physical findings also improved. A liver biopsy one year later demonstrated a marked improvement in hepatic fibrosis with no evidence of cirrhosis.
authors.affiliation: Internal Medicine Walter Reed Army Medical Center, Washington DC 20307, USA. franklin.goldwire@mac.com
authors.forename: Franklin-Whitney
authors.initials: FW
authors.lastname: Goldwire
authors.forename: William-E
authors.initials: WE
authors.lastname: Norris
authors.forename: Jonathan-M
authors.initials: JM
authors.lastname: Koff
authors.forename: Zachary-D
authors.initials: ZD
authors.lastname: Goodman
authors.forename: Milton-T
authors.initials: MT
authors.lastname: Smith
mesh_terms: D000328:Adult; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D015529:Choledochal Cyst / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000473:pathology; D014057:Tomography, X-Ray Computed