What is Ischemic cholangiopathy ?

Ischemic cholangiopathy is damage to one or more bile ducts caused by inadequate blood flow. Bile ducts (such as the liver vessels and bile ducts general), it is not like liver, supplied by the blood only from one of the great vessels, hepatic artery.

Thus, disturbances in blood flow through the hepatic artery can prevent bile ducts from getting enough oxygen. As a consequence, the cells lining the vessels damaged or die, this interference is called an ischemic cholangiopathy.

Blood flow can be disrupted with the things below:

Wounds from radiation therapy
Disorder that makes the blood easier to clot (clotting disorder).
Procedures to clog blood vessels leading to formation of clots (embolization).

Ischemic cholangiopathy is often seen in those who had a liver transplant.


SYMPTOMS
Damage to bile duct narrowing (constriction causes) so that the bile flow is slow or blocked. As a result, bile pigments (bilirubin) restrained, the skin and the whites of the eyes become yellow (called jaundice) and the urine becomes dark. When the bile (containing pigments such as bilirubin) did not go into the small intestine, feces became pale.

Itching (pruritus termed) are frequent, often begins in the hands and feet but usually affects the entire body. Itching worse particularly at night. Infection of the bile ducts (cholangitis) may also occur, resulting in abdominal pain, chills and fever.


Diagnosis
The diagnosis comes from the symptoms and abnormal results of blood tests, especially in people who have conditions that make more likely an ischemic cholangiopathy (eg, liver transplant recipients). Ultrasonography helps doctors described the vessel, but the results may not be convincing. Penentuani better often requires magnetic resonance imaging in the bile ducts (a procedure called magnetic resonance cholangiopancreatography or MRCP) or endoscopic retrograde cholangiopancreatography (ERCP).

ERCP involves entering seer elastic vessels (endoscope) through the mouth and into the small intestine and inject dye into the bile duct system.


TREATMENT
In addition to detect narrowing of the bile duct, ERCP can be used in the treatment. Cables with an empty balloon on its tip is inserted through the endoscope; doctors pumped the balloon to dilate the stricture (dilate). Connecting vessels (stent) and then keep the vessel open. People who have had liver transplants at any time require another transplant.