6q - dewal

[ArchivalUser]

A 30-year-old man with a 15-year history of ulcerative colitis develops intermittent cholestatic jaundice. Ultrasonographic examination fails to reveal gallstones. Liver biopsy
demonstrates a large bile duct obstruction. Which of the following would most likely be seen on endoscopic retrograde cholangiopancreatography (ERCP)?


Options:

A. Alternating constriction and dilatation of intrahepatic bile ducts

B. Markedly dilated common bile duct containing irregular radiolucent masses

C. Mass at the ampulla of Vater

D. Moderately dilated intrahepatic bile ducts and stricture in the bile duct at the porta hepatis

E. Very dilated biliary tree terminating in a blunt, nipple-like obstruction at the lower end of the common bile duct

[ArchivalUser]

b?

[ArchivalUser]

A. Alternating constriction and dilatation of intrahepatic bile ducts

[ArchivalUser]

Commom assoc. PSC and UC.

[ArchivalUser]

you r right okt3.
here is explanation.
The most likely diagnosis is primary sclerosing cholangitis, a disorder with a probable autoimmune component that is associated with ulcerative colitis (2/3 of primary sclerosing cholangitis patients have a history of ulcerative colitis). The disease is characterized by inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts, producing alternating strictures and dilatation of the structures. These changes are seen as "beading" on endoscopic retrograde cholangiopancreatography.

Gallstones in the biliary tree produce irregular radiolucent masses (choice B).

Choice C describes the findings associated with carcinoma of the ampulla of Vater.

Choice D describes the findings associated with carcinoma of the extrahepatic bile ducts.

Choice E describes the findings associated with carcinoma