Abstract

L. Dehou*, A. Ibrahimi, M. ElAbkari and H. Abid

ABSTRACT

Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease with a highly variable course, characterized by inflammatory and fibrosing involvement of the intra and/or extra-hepatic bile ducts, of unknown mechanism, but probably dysimmune, often associated with inflammatory colitis. (MICI). The evolution is very variable but potentially serious. The two main risks are the formation of secondary biliary cirrhosis and the occurrence of cholangiocarcinoma, which is very difficult to diagnose early. In addition, in case of associated IBD, there is a high risk of colon cancer justifying special monitoring. The diagnostic phase comprises several stages which are in fact parallel: 1) it is sclerosing cholangitis, 2) this cholangitis is not secondary, 3) what are the possible associated diseases? And 4) how severe is PSC? Non-invasive methods occupy a major place in the diagnosis and follow-up of PSC. The diagnosis of PSC is essentially based on imaging of the bile ducts. Thus the fibro-inflammatory nature of the biliary involvement is much more often retained on the MRI appearance than proven histologically.