ASGE Annual GI Advanced Practice Provider Course (Virtual) - Onboarding (Day One) | March 2025-Radiology Studies Case 2: Biliary Stricture

Video Transcription

Video Summary

The video discusses a clinical case study of a 25-year-old male with elevated liver enzymes and pruritus, likely linked to a history of ulcerative colitis. The initial suspicion leans towards primary sclerosing cholangitis (PSC), which is common in patients with inflammatory bowel disease. Diagnostic options such as MRCP, ERCP, and ultrasound are considered, with MRCP being the preferred initial test due to its non-invasive nature. The diagnosis reveals PSC, a progressive autoimmune disorder affecting the bile ducts. Management focuses on symptom relief, particularly pruritus, using pharmacotherapy like bile acid sequestrants. Although there's no curative treatment, potential interventions include managing dominant strictures and surveillance for associated cancers. In severe cases, liver transplantation is considered, with caution advised to avoid certain procedures that might disqualify patients from transplantation. Regular monitoring through colonoscopies is essential due to increased cancer risk.

Asset Subtitle

John A. Martin, MD, FASGE
Katelyn Cookson, PA-C

Keywords

primary sclerosing cholangitis

ulcerative colitis

pruritus

MRCP

bile acid sequestrants

liver transplantation