Manifestations vary with severity and rapidity of ischemic insult
Causes include arterial thrombosis, surgical injury, hypotension
Clinical Issues
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Prognosis varies depending on rapidity and extent of ischemic insult
Severe acute injury may lead to hepatic failure
Chronic ischemia leads to progressive obliteration of bile ducts, biliary cirrhosis, liver failure
Imaging
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Acute ischemic injury results in dilated bile ducts with filling defects due to biliary casts
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In chronic setting, diffuse stricturing and segmental dilatation of biliary tree seen by CT, MR, MRCP, or ERCP
Ischemic cholangitis is one cause of secondary sclerosing cholangitis
TERMINOLOGY
Synonyms
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Ischemic cholangiopathy