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Ketamine-related cholangiopathy: a retrospective study on clinical and imaging findings

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Abstract

Purpose: Ketamine is a commonly abused recreational drug in Southeast Asia. There are emerging reports on ketamine abuse causing liver injury and biliary dilatation. This retrospective study aims to investigate the clinical and radiological features of this condition. Methods: A retrospective search in the database of our institute was performed from January 2008 to February 2014 for patients who were ketamine abusers, with deranged liver function and/or epigastric pain, and had computed tomography of the abdomen or magnetic resonance cholangiopancreatography. Patient demographics, clinical data, and radiological findings were reviewed. Results: Twenty-six patients (11 male and 15 female) were included in this study. Eighteen (69 %) patients had fusiform dilatation of the common bile ducts (CBDs) without evidence of intrinsic or extrinsic obstruction, and non-dilated intrahepatic ducts. The degree of CBD dilatation correlated with duration of abuse. In five patients who achieved abstinence, the CBD dilatation showed improvement. Conclusions: Ketamine-related cholangiopathy manifested as fusiform dilatation of the CBD without evidence of obstructive lesions. Severity of CBD dilatation appears to be correlated with the duration of ketamine, and the condition is potentially reversible in abstinent patients.

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References

  1. Central Registry of Drug Abuse Sixty-First Report (2002–2011) http://www.nd.gov.hk/en/crda_61st_report.htm. Accessed 13 March 2014

  2. Substance Abuse and Mental Health Services Administration, Office of Applied Studies (2008) Use of Specific Hallucinogens. Rockville: Substance Abuse and Mental Health Services Administration, Office of Applied Studies

    Google Scholar 

  3. Chu PS, Kwok SC, Lam KM, et al. (2007) ‘Street ketamine’-associated bladder dysfunction: a report of ten cases. Hong Kong Med J = Xianggang yi xue za zhi/Hong Kong Acad Med 13(4):311–313

    Google Scholar 

  4. Chu PS, Ma WK, Wong SC, et al. (2008) The destruction of the lower urinary tract by ketamine abuse: a new syndrome? BJU Int 102(11):1616–1622. doi:10.1111/j.1464-410X.2008.07920.x

    Article  PubMed  Google Scholar 

  5. Wong SW, Lee KF, Wong J, et al. (2009) Dilated common bile ducts mimicking choledochal cysts in ketamine abusers. Hong Kong Med J = Xianggang yi xue za zhi/Hong Kong Acad Med 15(1):53–56

    CAS  Google Scholar 

  6. Seto WK, Ng M, Chan P, et al. (2011) Ketamine-induced cholangiopathy: a case report. Am J Gastroenterol 106(5):1004–1005. doi:10.1038/ajg.2010.485

    Article  PubMed  Google Scholar 

  7. Lui KL, Lee WK, Li MK (2014) Ketamine-induced cholangiopathy. Hong Kong Med J = Xianggang yi xue za zhi/Hong Kong Acad Med 20(1):78.e71–78.e72. doi:10.12809/hkmj133796

    Google Scholar 

  8. Gutkin E, Hussain SA, Kim SH (2012) Ketamine-induced biliary dilatation: from Hong Kong to New York. J Addict Med 6(1):89–91. doi:10.1097/ADM.0b013e3182399216

    Article  CAS  PubMed  Google Scholar 

  9. Lo RS, Krishnamoorthy R, Freeman JG, Austin AS (2011) Cholestasis and biliary dilatation associated with chronic ketamine abuse: a case series. Singap Med J 52(3):e52–e55

    CAS  Google Scholar 

  10. Wong GL, Tam YH, Ng CF, et al. (2014) Liver injury is common among chronic abusers of ketamine. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. doi:10.1016/j.cgh.2014.01.041

    Google Scholar 

  11. Danan G, Benichou C (1993) Causality assessment of adverse reactions to drugs—I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol 46(11):1323–1330

    Article  CAS  PubMed  Google Scholar 

  12. Haas DA, Harper DG (1992) Ketamine: a review of its pharmacologic properties and use in ambulatory anesthesia. Anesth Prog 39(3):61–68

    CAS  PubMed Central  PubMed  Google Scholar 

  13. Bachar GN, Cohen M, Belenky A, Atar E, Gideon S (2003) Effect of aging on the adult extrahepatic bile duct: a sonographic study. J Ultrasound Med Off J Am Inst Ultrasound Med 22(9):879–882; quiz 875–883

  14. Varadarajulu S, Tamhane A, Wilcox CM (2008) Prospective evaluation of adjunctive ketamine on sphincter of Oddi motility in humans. J Gastroenterol Hepatol 23(8 Pt 2):e405–e409. doi:10.1111/j.1440-1746.2007.05024.x

    Article  CAS  PubMed  Google Scholar 

  15. Ng SH, Tse ML, Ng HW, Lau FL (2010) Emergency department presentation of ketamine abusers in Hong Kong: a review of 233 cases. Hong Kong Med J = Xianggang yi xue za zhi/Hong Kong Acad Med 16(1):6–11

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    Wong-Li Yu, Carmen Chi-Min Cho, Phillip Fai-Ching Lung, Esther Hiu-Yee Hung, Joyce Wai-Yi Hui, Helen Hoi-Lun Chau & Anil T. Ahuja

  2. Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong

    Anthony Wing-Hung Chan

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  1. Wong-Li Yu
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  2. Carmen Chi-Min Cho
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  3. Phillip Fai-Ching Lung
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  4. Esther Hiu-Yee Hung
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  5. Joyce Wai-Yi Hui
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  6. Helen Hoi-Lun Chau
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  8. Anil T. Ahuja
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Correspondence to Carmen Chi-Min Cho.

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Yu, WL., Cho, C.CM., Lung, P.FC. et al. Ketamine-related cholangiopathy: a retrospective study on clinical and imaging findings. Abdom Imaging 39, 1241–1246 (2014). https://doi.org/10.1007/s00261-014-0173-2

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  • DOI: https://doi.org/10.1007/s00261-014-0173-2

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