Korean J Gastrointest Endosc > Volume 42(6); 2011 > Article
Korean Journal of Gastrointestinal Endoscopy 2011;42(6): 419-423.
A Case of Biliary Cast Syndrome in a Non-liver Transplant Patient
Sung Gon Jun, M.D., Seong Ran Jeon, M.D., Jong Ho Moon, M.D. and Young Deok Cho, M.D.
Department of Internal Medicine, Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul, Korea
Biliary casts are uncommon but are typically seen in post-liver transplant patients, whereas very few cases have been reported in non-liver transplant patients. A 65- year-old man, who had not undergone a liver transplantation or other hepatobiliary surgery, presented with jaundice and fever. Radiological imaging studies showed diffuse thickening and enhancement of the intrahepatic duct with mild ductal dilatation and multiple linear filling defects. A percutaneous transhepatic cholangioscopy revealed severe bile duct inflammation and multiple biliary casts, which were removed with multiple percutaneous choledocoscopic procedures. The pathogenesis of the biliary casts in this patient was uncertain. However, we presumed that biliary tract infection with subsequent extensive cholangitis was an important predisposing factor in the cast formation. We report a case of biliary cast syndrome with no preexisting morbidity that was managed favorably with endoscopic removal.
Key Words: Biliary cast, Biliary cast syndrome, Non-liver transplantation
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