Scheppach W, Druge G, Wittenberg G, Mueller J G, Gassel A M, Gassel H J, Richter F
Department of Medicine, the University of Wuerzburg, Wuerzburg, Germany.
Crit Care Med. 2001 Feb;29(2):438-41. doi: 10.1097/00003246-200102000-00042.
To describe three unusual cases of sclerosing cholangitis after severe extrahepatic/extrabiliary bacterial infections.
Case report, clinical.
Tertiary care intensive care unit (ICU).
Three patients admitted to the ICU with infections from Gram-positive bacteria followed by sclerosing cholangitis and secondary biliary cirrhosis.
Three unusual cases of persisting cholestasis that occurred after bacterial infections originating from extrahepatic/extrabiliary foci are described. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography revealed multiple strictures of the intrahepatic bile ducts as a sign of sclerosing cholangitis. All patients progressed to biliary cirrhosis within months after the onset of cholestasis.
Infection-associated cholestasis is usually a functional disorder and subsides after effective treatment of the underlying inflammatory focus. In rare cases, however, extrahepatic/extrabiliary infections may lead to sclerosing cholangitis and secondary biliary cirrhosis via unknown mechanisms.
描述严重肝外/胆管外细菌感染后发生的三例不寻常的硬化性胆管炎病例。
病例报告，临床研究。
三级医疗重症监护病房（ICU）。
三名入住ICU的患者，感染革兰氏阳性菌后发生硬化性胆管炎和继发性胆汁性肝硬化。
描述了三例源于肝外/胆管外病灶的细菌感染后持续存在胆汁淤积的不寻常病例。内镜逆行胰胆管造影和磁共振胰胆管造影显示肝内胆管多处狭窄，为硬化性胆管炎的征象。所有患者在胆汁淤积发作后的数月内均进展为胆汁性肝硬化。
感染相关性胆汁淤积通常是一种功能性障碍，在有效治疗潜在炎症病灶后会消退。然而，在罕见情况下，肝外/胆管外感染可能通过未知机制导致硬化性胆管炎和继发性胆汁性肝硬化。
