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Primary sclerosing cholangitis associated with liver atrophy.
N S Hadjis1, A Adam, I Blenkharn
1Hepatobiliary Surgical Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
American Journal of Surgery
|July 1, 1989
Summary
Primary sclerosing cholangitis can cause severe liver atrophy, impacting surgical approaches and mimicking cancer. This finding suggests liver atrophy is a key part of the disease spectrum.
Area of Science:
- Hepatology
- Gastroenterology
- Surgical Pathology
Background:
- Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by bile duct inflammation and fibrosis.
- PSC can lead to complications affecting liver function and structure.
Purpose of the Study:
- To investigate the occurrence and implications of gross lobar atrophy in patients with primary sclerosing cholangitis.
- To determine if liver atrophy is a recognized manifestation of PSC.
Main Methods:
- Retrospective analysis of 27 patients diagnosed with primary sclerosing cholangitis.
- Clinical investigation and surgical findings were reviewed.
- Follow-up data was assessed to exclude other pathologies.
Main Results:
- Four out of 27 PSC patients (approximately 15%) exhibited gross lobar atrophy.
- Atrophy was most severe in the hilar region of the liver.
- In two cases, atrophy led to exploratory laparotomy to rule out malignancy.
- Significant lobe size disparity complicated surgical management of biliary obstruction in two patients.
Conclusions:
- Gross lobar atrophy is a significant, albeit uncommon, manifestation in primary sclerosing cholangitis.
- Liver atrophy in PSC can present asymptomatically before jaundice and may mimic or complicate the diagnosis of malignancy.
- The findings support the inclusion of selective liver atrophy within the spectrum of PSC disease manifestations.
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