Korean J Gastroenterol.  2006 Aug;48(2):119-123.

Obstructive Jaundice due to Biliary Cast Syndrome Followed by Orthotopic Liver Transplantation

• Bak SH
• Choi HS
• Yang SY
• Jun DW
• Han SH
• Lee HL
• Lee OY
• Yoon BC
• Hahm JS
• Lee MH
• Lee DH
• Kee CS

Abstract

Biliary complication occurs in 6-34% of all liver transplant patients. Although bile leaks and strictures are relatively common, other biliary complications such as T-tube leak, choledocholithiasis, and biliary cast syndrome can also be observed. The biliary cast syndrome describes the presence of casts causing obstruction with its resultant sequelae of biliary infection, hepatocyte damage secondary to bile stasis and ductal damage, all contributing to cholangiopathy. Because the exact timing of cast formation after orthotopic liver transplantation is not consistent, it is difficult to define the true incidence of biliary cast syndrome without long-term follow-up data. Proposed etiological mechanisms include acute cellular rejection, prolongation of cold ischemic time, infection, biliary drainage tubes, and biliary obstruction. The diagnosis of biliary cast syndrome is usually confirmed by endoscopic retrograde cholangiopancreatography. There have been few published articles about biliary casts in Korea. Herein, we report a case of biliary cast syndrome followed by orthotopic liver transplantation.

Keyword

Biliary cast; Liver transplantation

MeSH Terms

Adult
Bile Duct Diseases/*complications/diagnosis/etiology
Female
Humans
Jaundice, Obstructive/*etiology
Liver Transplantation/*adverse effects
Male
Middle Aged
Retrospective Studies
Syndrome