| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000391013 |
| ISSN: | 1665-2681 |
| Authors: | Ben-Ari, Ziv1 Levingston, David1 Weitzman, Ella1 Haviv-Yadid, Yael1 Cohen-Ezra, Oranit1 Weiss, Peretz1 Zuckerman, Eli2 Inbar, Yael1 Amitai, Michal1 Rimon, Uri1 Goder, Maya1 Haik, Josef1 |
| Institutions: | 1Sheba Medical Center, Tel Aviv. Israel 2Carmel Medical Center, Liver Unit, Haifa. Israel |
| Year: | 2015 |
| Season: | Sep-Oct |
| Volumen: | 14 |
| Number: | 5 |
| Pages: | 695-701 |
| Country: | México |
| Language: | Inglés |
| Document type: | Estadística o encuesta |
| Approach: | Analítico |
| English abstract | Secondary sclerosing cholangitis in critically ill patients (SSC-CIP) is a relatively new previously unrecognized entity which may lead to severe biliary disease with rapid progression to cirrhosis. We present for the first time a case series of patients with rapidly progressive SSC-CIP requiring aggressive intensive care treatment following major burn injury. Results. SSC-CIP was diagnosed in 4 consecutive patients hospitalized due to major burn injuries at our Intensive Care Unit (ICU). SSC-CIP was diagnosed when ERCP (n = 1) or MRCP (n = 3) demonstrated irregular intrahepatic bile ducts with multiple strictures and dilatations and, when a liver biopsy (n = 3) demonstrated severe cholestasis and bile duct damage. All patients were males; none of whom had pre-existing liver disease. Ages: 18-56 y. All patients suffered from severe (grade 2-3) burn injuries with total burn surface area ranging from 35 to 95%. Mean length of ICU hospitalization was 129.2 ± 53.0 days. All patients required mechanical ventilation (with a mean PEEP of 8.4 ± 2.1 cm H2O) and the administration of catecholamines for hemodynamic stabilization. All patients demonstrated severe cholestasis. Blood cultures and cultures from drained liver abscesses grew hospital acquired multiple resistant bacteria. Liver cirrhosis developed within 12 months. One patient underwent orthotopic liver transplantation. Two patients (50%) died. In conclusion, SSC-CIP following major burn injury is a rapidly progressive disease with a poor outcome. Liver cirrhosis developed rapidly. Awareness of this grave complication is needed for prompt diagnosis and considerations of a liver transplantation |
| Disciplines: | Medicina |
| Keyword: | Diagnóstico, Gastroenterología, Colangitis esclerosante, Cirrosis, Quemaduras, Complicaciones |
| Keyword: | Medicine, Diagnosis, Gastroenterology, Sclerosing cholangitis, Cirrhosis, Burns, Complications |
| Full text: | Texto completo (Ver PDF) |
