2016 Volume 30 Issue 4 Pages 731-740
The patient was a 52-year-old male with no outstanding medical or allergic record. He had an acute cholangitis in August 20xx and received an elective cholecystectomy at other hospital. Although he had an almost good postoperative course, hepatic disorder that had been observed before the surgery became worse and detailed examination failed to detect a clear cause; thereafter he was introduced to our hospital. CT and MRCP revealed a focal biliary stenosis, and biliary drainage was performed with ERCP. He was diagnosed as an eosinophilic cholangitis based on eosinophil infiltration in the biliary duct wall of the biopsy sample from the stenosis area as well as increased eosinophil counts in the peripheral blood. After the drainage, biliary stenosis was ameliorated, and only follow-up observation without steroid therapy was selected based on his wishes. The untreated follow-up observation has been continued for a year, and bile duct images as well as hepatobiliary enzyme levels have been normalized.
We here report a case of eosinophilic cholangitis under the follow-up observation without steroid therapy together with literature review discussion.
