Characteristics of primary sclerosing cholangitis in the USA

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown etiology that is frequently associated with inflammatory bowel disease. It is characterized by diffuse inflammation and fibrosis of the biliary tree, and it usually leads to biliary cirrhosis and portal hypertension. PSC is most commonly diagnosed with endoscopic retrograde cholangiopancreatography, although magnetic resonance cholangiography (MRC) is rapidly emerging as a first choicediagnostic test. MRC has the advantage of being non-invasive, does not require radiation, and is cost-effective in that it does not carry the risk of pancreatitis associated with retrograde studies. 2 Percutaneous cholangiography is seldom performed anymore.