ERCP and EUS/IDUS Features



IgG4-related sclerosing cholangitis (IgG4-SC) has a frequent association with autoimmune pancreatitis and is an important component of IgG4-related disease. The diagnosis may be difficult to establish, often mimicking malignancy or primary sclerosing cholangitis. While a range of serological, pathological, and noninvasive imaging features may support a diagnosis of IgG4-SC, endoscopic features remain an important means by which to make a definitive diagnosis and manage the disease. Endoscopic retrograde cholangiopancreatography (ERCP) is often required in the patient presenting with obstructive jaundice, and a diagnosis of IgG4-SC may be advanced by close attention to biliary and pancreatic ductal anatomy. Endoscopic brush cytology (and importantly endoscopic biopsies for histology and immunostaining) may both exclude malignancy and establish a diagnosis of IgG4-SC. Endoscopic and intraductal ultrasound may further define parenchymal and duct wall anatomy and also allows transmural tissue sampling.


Bile Duct Primary Sclerosing Cholangitis Sclerosing Cholangitis Biliary Stricture Duodenal Papilla 
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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.GI ServicesUniversity College London HospitalsLondonUK
  2. 2.Department of GastroenterologyFukushima Medical University Aizu Medical CenterAizuwakamatsuJapan

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