Cholangiographic abnormalities in ulcerative colitis associated pericholangitis which resemble sclerosing cholangitis

Cholangiographic abnormalities in asymptomatic patients with pericholangitis and longstanding ulcerative colitis, which resemble sclerosing cholangitis, have not been previously reported. Endoscopic retrograde cholangiography (ERC) performed in one such patient suggesting intrahepatic sclerosing cholongitis stimulated the study of seven additional patients with largely asymptomatic pericholangitis. In seven of these eight patients. ERC demonstrated abnormalities which resembled sclerosing cholangitis. These consisted of beading and structures mainly of the intrahepatic biliary tree (IHB). In two of the eight, the common bile duct was involved. In one, this was associated with histologic progression to cirrhosis and frank cholangitic episodes even though the initial clinical presentation and hepatic histology 2 1/2 years earlier suggested only pericholangitis. We therefore conclude that bile duct abnormalities resembling sclerosing cholangitis may be demonstrated cholangiographically in patients with ulcerative colitis who present with the typical picture of pericholangitis.