Exact(4)
These pancreatic duct appearances have been corroborated with endoscopic retrograde cholangiopancreatography (ERCP) findings, with one multicentre study suggesting that four key features on ERCP are: (1) long (more than one-third the length of the pancreatic duct) stricture; (2) lack of upstream dilatation (<5 mm); (3) multiple strictures; (4) side branches arising from a strictured segment [28].
While Julia was disciplined for infractions of the multiple strictures that her unfeeling parents imposed, she does not recall being touched.
The frequencies of long stricture without marked upstream dilation, of multiple strictures without marked upstream dilation, of segmental/focal narrowing without marked upstream dilation and of marked upstream dilation of the MPD were evaluated.
In the absence of this, the diagnosis was also made if patients had classical radiological features of AIP (diffusely enlarged pancreas with delayed enhancement and capsule-like rim; diffusely irregular, attenuated main pancreatic duct or multiple strictures or long stricture without upstream dilatation) and an elevated serum IgG4 > 2 × upper limit of normal (ULN) (>1.72 g/L).
Similar(56)
b Coronal MIP reformat in a different patient with more advanced PSC with multiple intrahepatic strictures and strictures seen in the common hepatic duct and distal CBD (arrows).
MR enteroclysis (a) axial fat-saturated true-FISP image demonstrates multiple irregular strictures (white arrows) of the distal small bowel with slight bowel wall thickening, prestenotic small bowel dilatation (open arrow) and no mass.
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown etiology [ 1] characterized by classic findings of multiple segmental strictures in the intra- and extra-hepatic bile ducts secondary to inflammation and obliterative fibrosis.
Ten months after the initial presentation the patient had a third episode of cholangitis; ERCP then showed hilar biliary stenoses as well as multiple filliform strictures of segmental intrahepatic bile ducts associated with peripheral duct dilatation.
Tanaka et al. described a patient who developed multiple intrahepatic biliary strictures after pyogenic cholangitis caused by Klebsiella and Enterococcus, that occurred as a complication of colonoscopic polypectomy.
The colonoscopic features were defined as ulcers, nodules, deformed cecum and ileocecal valve, strictures, multiple fibrous bands and polypoid lesions [ 17].
However, as the stenting of her right kidney was unsuccessful, attributed to multiple intra-renal strictures and irregularity of the urothelial outline, a percutaneous nephrostomy tube was inserted to allow long-term drainage.
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