An atypical presentation of biliary cast syndrome (BCS)

A 33-years-old man underwent liver transplantation for decompensated cirrhosis in August 2014. Eight weeks after transplantation, he presented a significant rise in cholestasis and diffuse biliary dilation. Neither biliary strictures or biliary casts (BC) were detected on non-enhanced T1-weighted sequences (Panel A) in MRI. An ERCP was subsequently performed with diagnosis of intra-ductal casts. The patient was re-transplanted in December 2014. In the explant, diffuse BCs were detected inside the biliary tree (Panel  B).

Source: Digestive and Liver Disease - August 16, 2020 Category: Gastroenterology Authors: Chiara Mazzarelli, Raffaella Vigan ò, Marcello Vangeli, Angelo Vanzulli Tags: Image of the Month Source Type: research