抄録
Primary sclerosing cholangitis is a rare disease of unknown etiology, a diffuse obliteration and fibrosis of the extra and intrahepatic biliary tree in the abscence of biliary stones, recent operative trauma, cancer or in-fection. Diagnosis of this disease has been made at operative cholangiogram and histological survey, in most of the cases, and only a few cases diagnosed by ERCP so far reported. By performing ERCP in 3 jaundiced patients, we experienced the interesting radiographic appearance of P. S. C. and other similar diseases. Case l; a 49-year-old woman with episodes of pruritis and general fatigue also complained of several episodes of anal bleeding. Highly elevated value of serum alk. alive phosphatase in contrast to slight degree of hyper-bilirubinemia. was noted. Symptoms, laboratory data indicates the diagnosis of P. S. C. and ERCP showed beaded appearance. Final diagnosis was made as P. S. C. with association of ulcerative colitis. Case 2; A 56-year-old male with painless jaundice and general fatigue. The blood chemistry was not so charact-aristic of P. S. C. but ERCP showed segmental narrowing of the hilar bile duct and histological findings of the wedge-type resection was suggestive of segmental S. C.. Case 3; A 43-year-old male with severe jaundice died of renal failure after the one year history of jaundice. ERCP showed string-like caliber of the common hepatic duct and both hepatic ducts with area of striking proximal dilatation. The findings of ERCP and his clinical course suggested that this case might have a .scirrhous carcinoma, although autopsy. was unable to be performed.
