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Updated: Sep 2, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
[Rare initial manifestation and differential diagnosis of primary sclerosing cholangitis]
B Rehermann1, K Klugewitz, U Seifert
1Abteilung Gastroenterologie und Hepatologie, Zentrum Innere Medizin und Dermatologie, Medizinische Hochschule Hannover.
Background:
Primary sclerosing cholangitis is most often diagnosed in middle-aged men who are suffering from inflammatory bowel diseases.
Case Report:
A young, previously healthy woman presents with icterus of acute onset, high transaminases and positive hepatitis B virus serology. Ultrasound and nuclear magnetic resonance images demonstrate multiple liver tumors. After acute viral hepatitis as well as primary or secondary malignant liver tumors have been excluded as underlying diseases, diagnosis of primary sclerosing cholangitis is made.
Conclusion:
Differential diagnosis of primary sclerosing cholangitis should also be considered in cases with untypical primary presentation.
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