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Pathology
Increased incidence in patients with PSC
Usually patients are asymptomatic until they become jaundiced due to obstruction
Aetiology
Jaundice, pruritus, weight loss, abdominal pain
Signs
Painless jaundice and palpable gall bladder
Symptoms
Jaundice, pruritus, weight loss, abdominal pain
Investigations
Bloods: LFTs show an increased bilirubin and ALP
Tumour Markers: CA 19-9 and CEA may be raised
Imaging: Ultrasound Abdomen or MRCP shows dilated bile ducts. ERCP allows for
tissue biopsy
Treatment
Medical: ERCP to insert stent in bile duct and relieve Obstruction
Surgical: Resection is rarely possible. Radical hepatectomy and bile duct excision is
curative. Liver transplantation.
Prognosis
Poor, frequently due to late presentation.
2-8 month survival if treated palliatively.
Infection of biliary tree and obstruction
Key Facts
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Key References
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