Korean J Gastrointest Endosc.
2003 Oct;27(4):254-257.
A Case of Biliary Cast with a Characteristic Finding on ERCP
- Affiliations
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- 1Department of Internal Medicine, Sung Ae Hospital, Korea. kimhkgi@hanmail.net
- 2Department of Internal Medicine, Kwang Myung Sung Ae Hospital, Korea.
- 3Department of Internal Medicine, Asan Medical Center, Ulsan University College of Medicine, Korea.
Abstract
- Cast formation of biliary sludge leading to obstruction and cholangitis have been reported in patients who received orthotopic liver transplantation. The pathogenesis of biliary cast after orthotopic liver transplantation appeared to be multifactorial. Cold ischemic damage, immunologic attack to the bile duct and bile stasis may have played a role. On the other hand, only three cases of biliary cast have been reported in non-transplanted patients. We described the successful endoscopic removal of this complication in a 70-year-old man whose biliary sludge aggregated into firm casts occupying the extrahepatic ducts which has been developed after cholecystectomy and segmentectomy for intrahepatic cholangiocarcinoma. We speculated on the hemolysis and prolonged fasing as the initiating events but the exact pathogenesis of biliary cast remains to be clarified.
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