Primary sclerosing cholangitis diagnosis and management

Primary sclerosing cholangitis is a progressive cholestatic liver disease of unknown etiology. The disease is characterized by inflammation and progressive fibrosis of the biliary tree with subsequent development of cirrhosis with risk of portal hypertension, liver failure and cancer. There is currently no treatment that has been shown to reverse or stabilize disease progression. Endoscopic retrograde cholangiopancreatography is important in making the diagnosis as well as palliating the effects of biliary obstruction. This article discusses the epidemiology, pathogenesis, clinical presentation, diagnosis, and management of primary sclerosing cholangitis with an emphasis on endoscopic principles and techniques.