Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2007; 13(13): 1995-1997
Published online Apr 7, 2007. doi: 10.3748/wjg.v13.i13.1995
A case of eosinophilic cholangitis: Imaging findings of contrast-enhanced ultrasonography, cholangioscopy, and intraductal ultrasonography
Naoki Matsumoto, Kiyoshi Yokoyama, Kazuhiko Nakai, Toshiki Yamamoto, Takeshi Otani, Masahiro Ogawa, Naohide Tanaka, Ariyoshi Iwasaki, Yasuyuki Arakawa, Masahiko Sugitani
Naoki Matsumoto, Kiyoshi Yokoyama, Kazuhiko Nakai, Toshiki Yamamoto, Takeshi Otani, Masahiro Ogawa, Naohide Tanaka, Ariyoshi Iwasaki, Yasuyuki Arakawa, Department of Gastroenterology and Hepatology, Nihon University Surugadai Hospital, 1-8-13, Kandasurugadai, Chiyoda-ku, Tokyo 101-8309, Japan
Masahiko Sugitani, Department of Pathology, Nihon University School of Medicine, 30-1, Oyaguchikamimachi, Itabashi-ku, Tokyo 101-8309, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Naoki Matsumoto, Department of Gastroenterology and Hepatology, Nihon University Surugadai Hospital, 1-8-13, Kandasurugadai, Chiyoda-ku, Tokyo 101-8309, Japan. nm3802@med.nihon-u.ac.jp
Telephone: +81-3-32931711 Fax: +81-3-32936078
Received: February 4, 2007
Revised: March 3, 2007
Accepted: March 23, 2007
Published online: April 7, 2007
Abstract

A 38-year-old woman was referred to our institution due to epigastralgia. She presented with obstructive jaundice and eosinophilia. Endoscopic retrograde cholangiopancreatography showed diffuse narrowing from the distal common bile duct to the bifurcation of the hepatic ducts. An endoscopic plastic biliary stent was inserted; the specimen obtained from the common bile duct wall revealed dense infiltration by eosinophils. Treatment was started with prednisolone 60 mg daily. The patient’s biliary stenosis and eosinophilia gradually improved. Eosinophilic infiltration in the lungs or stomach is relatively common, but it is rare in the common bile duct. Most of the reported cases of eosinophilic cholangitis presented with eosinophilia; our patient’s eosinophil count was over 1000/mm3. Since our patient had allergies to pollen and house dust, a relationship between the allergies and the eosinophilic cholangitis was suspected, but no cause was identified.

Keywords: Eosinophilic cholangitis; Sclerosing cholangitis; Contrast-enhanced ultrasonography; Cholangioscopy; Intraductal ultrasonography