A 35 year old male presenting with recurrent episodes of abdominal pain, jaundice and fatigue underwent MRCP (shown below). What is the most likely diagnosis?
Correct Answer: Primary Sclerosing Cholangitis
Description: The given MRCP image which shows multiple intrahepatic and extrahepatic segments of stricturing, along with given clinical features are suggestive of Primary sclerosing cholangitis. Primary Sclerosing Cholangitis (PSC) PSC is a chronic cholestatic syndrome that is characterized by diffuse inflammation and fibrosis involving the entire biliary tree, resulting in chronic cholestasis. It leads to obliteration of both the intra- and extrahepatic biliary tree, leading to biliary cirrhosis, poal hypeension, and liver failure. Patient usually presents with fatigue , pruritis , and upper abdominal pain. Jaundice and icterus may also be present 70% cases are associated with IBD. On MRCP, it shows shows multiple intrahepatic and extrahepatic segments of stricturing , known as "Prune tree appearance". Figure1: MRCP image showing Primary Sclerosing Cholangitis Figure 2: Actual picture of tree with pruning
Category:
Radiology
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