ERCP and EUS/IDUS Features

  • George Webster
  • Atsushi Irisawa


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 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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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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