Pediatric Primary Sclerosing Cholangitis

  • Etiology:
  • Imaging:
    — Strictures of biliary tree and dilated biliary ducts can give a beaded appearance to biliary tree
    — Pruned appearance to intrahepatic ducts
  • Imaging MRCP: Can overestimate degree of stricture
  • DDX:
  • Complications:
  • Treatment:
  • Clinical: Associated with inflammatory bowel disease – Crohn disease and ulcerative colitis (more commonly)

Radiology Cases of Primary Sclerosing Cholangitis

ERCP of primary sclerosing cholangitis
AP image from an ERCP exam shows a beaded appearance to the biliary tree with multiple strictures causing multiple focal dilations of the biliary ducts. Overall, there is a pruned appearance to the intrahepatic biliary tree.