title: Retraction of the main papilla toward the biliary system in patients with primary sclerosing cholangitis.
abstract: OBJECTIVE
  Retraction of the main papilla toward the biliary system was observed in 70% of patients with primary sclerosing cholangitis (PSC). However, this observation was confounded by the fact that all of the patients with this finding had a prior history of sphincterotomy. The aim of the present study was to observe whether main papillary retraction can be seen in patients with naïve papillae and accompanies the progression of the disease.
  
  
  METHODS
  The study was conducted in a single tertiary reference center and included 4 patients with PSC.
  
  
  RESULTS
  Main papillary retraction was seen to emerge with progression of PSC after an initial presentation with intra and extrahepatic involvement in 2 patients and after progression from intrahepatic to extrahepatic bile ducts in 1 patient. Main papillary retraction was seen in 2 patients with naïve papillae and could be detected by magnetic resonance cholangiography in 1 patient.
  
  
  CONCLUSIONS
  Retraction of the main papilla can be seen in patients with PSC regardless of prior sphincterotomy history.
authors.affiliation: Department of Gastroenterology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey. koksalas@yahoo.com.
authors.forename: Erkan
authors.initials: E
authors.lastname: Parlak
authors.forename: Aydın Şeref
authors.initials: AŞ
authors.lastname: Köksal
authors.forename: Selçuk
authors.initials: S
authors.lastname: Dişibeyaz
authors.forename: Bahattin
authors.initials: B
authors.lastname: Çiçek
authors.forename: Bülent
authors.initials: B
authors.lastname: Ödemiş
authors.forename: Nurgül
authors.initials: N
authors.lastname: Şaşmaz
authors.forename: Burhan
authors.initials: B
authors.lastname: Şahin
mesh_terms: D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D001659:Biliary Tract; D015209:Cholangitis, Sclerosing / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged