Pericholangitis Clinical Presentation

Updated: Jun 22, 2016
  • Author: Robert P Myers, MD, FRCPC; Chief Editor: BS Anand, MD  more...
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Presentation

History

Symptoms of patients with pericholangitis vary considerably, depending on the reported series. Frequently, the diagnosis is made in asymptomatic patients with inflammatory bowel disease (IBD) when routine liver biochemistry studies reveal a cholestatic liver profile.

Other patients present with cholestatic features, including jaundice and pruritus. Jaundice may develop insidiously or occur as abrupt intermittent episodes of icterus. Finally, some patients may present with typical features of acute cholangitis—namely, fever, jaundice, and abdominal pain.

In a minority of patients, pericholangitis progresses to severe fibrosis and cirrhosis. In these patients, features of hepatic decompensation (eg, the development of ascites, edema, bleeding related to portal hypertension, or hepatic encephalopathy) may predominate.

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Physical Examination

The physical examination findings in patients with pericholangitis are usually unremarkable. Abnormal physical findings include the following:

  • Jaundice

  • Hepatomegaly

  • Ascites and edema

  • Stigmata of chronic liver disease (spider angiomata), leukonychia, muscle wasting, gynecomastia and testicular atrophy (in men), and palmar erythema

  • Skin excoriations due to pruritus

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