title: Ketamine-related cholangiopathy: a retrospective study on clinical and imaging findings.
abstract: OBJECTIVE
  Ketamine is a commonly abused recreational drug in Southeast Asia. There are emerging reports on ketamine abuse causing liver injury and biliary dilatation. This retrospective study aims to investigate the clinical and radiological features of this condition.
  
  
  METHODS
  A retrospective search in the database of our institute was performed from January 2008 to February 2014 for patients who were ketamine abusers, with deranged liver function and/or epigastric pain, and had computed tomography of the abdomen or magnetic resonance cholangiopancreatography. Patient demographics, clinical data, and radiological findings were reviewed.
  
  
  RESULTS
  Twenty-six patients (11 male and 15 female) were included in this study. Eighteen (69 %) patients had fusiform dilatation of the common bile ducts (CBDs) without evidence of intrinsic or extrinsic obstruction, and non-dilated intrahepatic ducts. The degree of CBD dilatation correlated with duration of abuse. In five patients who achieved abstinence, the CBD dilatation showed improvement.
  
  
  CONCLUSIONS
  Ketamine-related cholangiopathy manifested as fusiform dilatation of the CBD without evidence of obstructive lesions. Severity of CBD dilatation appears to be correlated with the duration of ketamine, and the condition is potentially reversible in abstinent patients.
authors.affiliation: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Wong-Li
authors.initials: WL
authors.lastname: Yu
authors.forename: Carmen Chi-Min
authors.initials: CC
authors.lastname: Cho
authors.forename: Phillip Fai-Ching
authors.initials: PF
authors.lastname: Lung
authors.forename: Esther Hiu-Yee
authors.initials: EH
authors.lastname: Hung
authors.forename: Joyce Wai-Yi
authors.initials: JW
authors.lastname: Hui
authors.forename: Helen Hoi-Lun
authors.initials: HH
authors.lastname: Chau
authors.forename: Anthony Wing-Hung
authors.initials: AW
authors.lastname: Chan
authors.forename: Anil T
authors.initials: AT
authors.lastname: Ahuja
mesh_terms: D000328:Adult; D001649:Bile Duct Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D001652:Bile Ducts / Q000473:pathology; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis*; D002758:Cholangiography / Q000379:methods; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods; D004108:Dilatation, Pathologic / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning; D007649:Ketamine / Q000506:poisoning*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D013287:Illicit Drugs; D007649:Ketamine