Aids Cholangiopathy

AIDS cholangiopathy is a bile duct obstruction that follow strictures of the biliary tract, which in turn are caused by various opportunistic infections.

(See also Overview biliary function.)

AIDS cholangiopathy is a bile duct obstruction that follow strictures of the biliary tract, which in turn are caused by various opportunistic infections. (See also Overview biliary function.) Before the advent of antiretroviral therapy, the prevalence of cholangiopathy 25% in patients with AIDS, particularly in patients with a low CD4 cell count was (<100 / ul). The most common pathogen is Cryptosporidium parvum. Others are cytomegalovirus, microsporidia and Cyclospora sp. Papillary or intra- and extrahepatic sclerosing cholangitis develops in most patients. More than half of patients have both. Common symptoms are pain in the right upper quadrant and epigastric and diarrhea. Some patients have fever and jaundice Severe pain point generally to a papillary stenosis. Slight pain suggests a sclerosing cholangitis. Diarrhea reflects the small intestine infection resist, often due to cryptosporidium. Most diagnostic sonography and ERCP The imaging examination usually begins with ultrasound, the non-invasive and very accurate (> 95%) is. However, usually a ERCP is necessary. ERCP provides the diagnosis and allows the identification of the pathogen by means of duodenal biopsy and, if appropriate therapeutic intervention at significant stenoses. CT and MR cholangiopancreatography usually have more complementary role. Pathological liver function tests (especially high alkaline phosphatase levels) suit cholestasis. Therapy Endoscopic procedures Endoscopic sphincterotomy, which is often done during ERCP can significantly reduce pain, jaundice and cholangitis in patients with papillary stenosis. Isolated or dominant stenosis can be dilated endoscopically and supplied with a stent. Antimicrobial therapy is given to treat the infection, but does not reduce the bile duct damage alone or does not relieve the symptoms. In analogy to their use at PSC and PBC, ursodeoxycholic acid may have a role in the treatment of intrahepatic cholestasis and transitional sclerosis.

Health Life Media Team

Leave a Reply