BOF: 2.26
A 40 year old male presents who is known to have
ulcerative colitis which is in remission presents with fever, abdominal pain,
pruritus and jaundice. An ERCP is performed and this shows intra-hepatic and
extra-hepatic biliary strictures.
In the long-term this patient is at increased risk of:
a)
Hepatocellular carcinoma
b)
Pancreatic carcinoma
c)
Cholangiocarcinoma
d)
Adenocarcinoma of the oesophagus
e)
Lung cancer
Answer:
c)
The clinical features are suggestive of cholangitis and
the ERCP findings are those of primary sclerosing cholangitis, which is a
known complication of ulcerative colitis. In this condition cholangiocarcinoma
can occur in up to 20 % of patients.
