Elsevier

Human Pathology

Volume 13, Issue 1, January 1982, Pages 19-24
Human Pathology

Bile ductular cholestasis: An ominous histopathologic sign related to sepsis and “cholangitis lenta”

https://doi.org/10.1016/S0046-8177(82)80134-2Get rights and content

An unusual form of intrahepatic cholestasis manifested by inspissated bile within dilated and proliferated portal and periportal bile ductules was seen in liver biopsy and autopsy specimens from three patients. Features of sepsis and severe systemic illness with jaundice dominated their clinical presentations, and no autopsy evidence of large bile duct obstruction could be found. This lesion may be related to the old entity, “cholangitis lenta”, a form of chronic sepsis associated with biliary tract inflammation in the absence of demonstrable extrinsic obstruction. Identification of this pattern of cholestasis in liver biopsy specimens is useful in certain patients who may be at great risk of mortality and who require serious clinical attention directed toward elucidating a source for sepsis as well as aggressive management of other systemic diseases. Laparotomy in such cases will be unrewarding and may hasten the patient's demise.

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Assistant Professor of Pathology, Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, New York.

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