Biliary cast formation with sclerosing cholangitis in critically ill patient: case report and literature review

Korean J Radiol. 2012 May-Jun;13(3):358-62. doi: 10.3348/kjr.2012.13.3.358. Epub 2012 Apr 17.


Sclerosing cholangitis in critically ill patients (SC-CIP) is a rare condition that is not familiar to many radiologists. In addition, the associated imaging findings have not been described in the radiological literature. We report a case of biliary cast formation with SC-CIP and describe the radiological findings of CT, magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiography (ERC). A diagnosis of SC-CIP should be considered in intensive care unit (ICU) patients with persistent cholestasis during or after a primary illness. The typical CT, MRCP and ERC findings include new biliary casts in the intrahepatic duct with multiple irregular strictures, dilatations, and relative sparing of the common bile duct.

Keywords: Biliary cast formation; CT; Magnetic resonance cholangiopancreatography; Sclerosing cholangitis; Sclerosing cholangitis in critically ill patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cholangiopancreatography, Endoscopic Retrograde
  • Cholangiopancreatography, Magnetic Resonance
  • Cholangitis, Sclerosing / diagnosis*
  • Cholangitis, Sclerosing / drug therapy
  • Contrast Media
  • Critical Illness*
  • Cryptogenic Organizing Pneumonia / diagnosis
  • Cryptogenic Organizing Pneumonia / surgery
  • Diagnosis, Differential
  • Humans
  • Liver Function Tests
  • Male
  • Thoracic Surgery, Video-Assisted
  • Tomography, X-Ray Computed


  • Contrast Media