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Pericholangitis in Chronic Ulcerative Colitis: Primary Sclerosing Cholangitis of the Small Bile Ducts?

AILEEN WEE, M.B., B.S.; and JURGEN LUDWIG, M.D.
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▸Requests for reprints should be addressed to Jurgen Ludwig, M.D.; Department of Pathology, Section of Medical Pathology, Mayo Clinic; Rochester, MN 55905.


Rochester, Minnesota


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(5):581-587. doi:10.7326/0003-4819-102-5-581
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Review of liver biopsy specimens, autopsy specimens, and clinical records of 107 patients with chronic ulcerative colitis and hepatobiliary diseases showed "pericholangitis" (defined as small-duct primary sclerosing cholangitis) in 37 (35%), primary sclerosing cholangitis (defined as large-duct primary sclerosing cholangitis) in 18 (17%), chronic active hepatitis in 14 (13%), cryptogenic cirrhosis in 12 (11%), and miscellaneous lesions including malignancies in 26 (24%). Documented cirrhosis was present or developed in 37 patients (35%). The spectrum of histologic features of small-duct primary sclerosing cholangitis was indistinguishable from that of confirmed large-duct primary sclerosing cholangitis. In 6 of the 18 patients who eventually developed the large-duct disease, biopsy evidence 1 to 12 years earlier had shown small-duct primary sclerosing cholangitis. Thus, small-duct and large-duct primary sclerosing cholangitis seem to be components of a disease spectrum.

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