Introduction: Secondary sclerosing cholangitis in critically ill patients (SSC-CIP) is a rare but underdiagnosed entity that occurs after life-threatening events and treatment in the intensive care unit (ICU).The etiology of SSC-CIP is not fully understood but may be caused by ischemic bile duct injury.SSC-CIP is a cholestatic liver disease that rapidly progresses to liver cirrhosis, with a high mortality rate in the first year of 50%.Endoscopic retrograde cholangiopancreatography (ERCP), which is the gold standard for diagnosing SSC-CIP, shows primary SC-like changes, usually in the intrahepatic bile ducts.Biliary cast formation is pathognomonic for SSC-CIP.
No Hair Colour Remover proven effective conservative treatment is available for SSC-CIP, and liver transplantation is the only curative therapy when liver cirrhosis Spin Mop or recurrent cholangitis occurs.Case Presentation: We report the case of a 47-year-old male patient who developed cholestasis after a long treatment in the ICU for severe pneumonia.ERCP showed characteristic findings with rarefication and multiple segmental stenosis in the intrahepatic bile ducts.We removed multiple biliary casts from the bile ducts.Conclusion: SSC-CIP should be considered for ICU patients with unclear cholestasis, especially when the cholestasis persists after recovery from the underlying disease.
Early diagnosis is important to achieve better outcomes; without liver transplantation, the prognosis is generally poor.