Secondary sclerosing cholangitis

Secondary sclerosing cholangitis (SSC) is a chronic liver disease that results from the progressive inflammation and scarring of the bile ducts within the liver. This condition is termed "secondary" as it occurs due to an identifiable cause or condition, unlike primary sclerosing cholangitis (PSC), which has no known cause.

Etiology

The exact cause of SSC is not fully understood, but it is known to be associated with several conditions such as ischemia, sepsis, trauma, and immunodeficiency. It can also occur as a complication of surgical procedures or due to the use of certain medications.

Pathophysiology

In SSC, the inflammation and scarring of the bile ducts lead to their narrowing and obstruction. This results in the accumulation of bile in the liver, causing further inflammation and eventually leading to cirrhosis and liver failure.

Clinical Presentation

Patients with SSC often present with symptoms such as jaundice, pruritus, and fatigue. They may also have signs of advanced liver disease such as ascites, hepatic encephalopathy, and variceal bleeding.

Diagnosis

The diagnosis of SSC is typically made based on a combination of clinical features, laboratory findings, imaging studies, and sometimes, liver biopsy. The presence of cholangiographic abnormalities such as multifocal strictures and dilatations in the bile ducts is a key diagnostic feature.

Treatment

The treatment of SSC is primarily aimed at managing the symptoms and slowing the progression of the disease. This may involve the use of medications to reduce inflammation and improve bile flow, endoscopic procedures to relieve bile duct obstruction, and in severe cases, liver transplantation.

Prognosis

The prognosis of SSC varies widely and depends on several factors including the underlying cause, the extent of liver damage, and the patient's overall health status.

See Also

• Primary sclerosing cholangitis
• Cholangitis
• Liver transplantation