Korean J Gastrointest Endosc.  2011 Jun;42(6):419-423.

A Case of Biliary Cast Syndrome in a Non-liver Transplant Patient

• Jun SG
• Jeon SR
• Moon JH
• Cho YD

Abstract

Biliary casts are uncommon but are typically seen in post-liver transplant patients, whereas very few cases have been reported in non-liver transplant patients. A 65-year-old man, who had not undergone a liver transplantation or other hepatobiliary surgery, presented with jaundice and fever. Radiological imaging studies showed diffuse thickening and enhancement of the intrahepatic duct with mild ductal dilatation and multiple linear filling defects. A percutaneous transhepatic cholangioscopy revealed severe bile duct inflammation and multiple biliary casts, which were removed with multiple percutaneous choledocoscopic procedures. The pathogenesis of the biliary casts in this patient was uncertain. However, we presumed that biliary tract infection with subsequent extensive cholangitis was an important predisposing factor in the cast formation. We report a case of biliary cast syndrome with no preexisting morbidity that was managed favorably with endoscopic removal.

Keyword

Biliary cast; Biliary cast syndrome; Non-liver transplantation

MeSH Terms

Aged
Bile Ducts
Biliary Tract
Cholangitis
Dilatation
Fever
Humans
Inflammation
Jaundice
Liver Transplantation
Superior Mesenteric Artery Syndrome
Transplants