ACASE REPORT OF PRIMARY SCLEROSING CHOLANGITIS WITH ULCERATIVE COLITIS

Abstract

A24-year-old women was admitted to our hospital for evaluation of hepatic dysfunction. She was diagnosed as ulcerative colitis in our hospital in 1987(at age of 16). She wastreated with salazosulfapyridine and prednisolone, and she had been well with no relapsefor four years. Endoscopic retrograde cholangiogram showed beaded appearances of theintrahepatic bile ducts and irregular stricture of the intra-and extrahepatic bile ducts.Hepatic needle biopsy revealed mild periductal fibrosis. She had no history of bile ductsurgery and choledochlithiasis. From overall results, she was diagnosed as primarysclerosing cholangitis. We confirmed that the remission of ulcerative colitis by bariumenema study and colonoscopy. Reported cases of primary sclerosing cholangitis associated with ulcerative colitis inJapan were reviewed. The most cases had pancolitis, and sclerosing change of intra-andextrahepatic bile ducts. Whether primary sclerosing cholangitis might precede or followulcerative colitis remains to be controversial. This case was daignosed before the development of irreversible fibrosis, and responsive to steroid therapy.