Patient selection: chronic hepatic schistosomiasis with portal hypertension and preserved hepatic function
Findings associated with anicteric cholangiopathy:
(1) unexplained rise in serum GGT (not due to alcohol use, viral hepatitis, etc)
(2) rise in serum alkaline phosphatase to a lesser degree
(3) absence of jaundice
(4) abnormal MRCP (magnetic resonance cholangiopancreatography, see below)
(5) exclusion of primary biliary cirrhosis and primary sclerosing cholangitis
(6) exclusion of other infections (based on a negative CRP)
(7) rapid improvement following therapy with ursodeoxycholic acid
Abnormalities seen on MRCP:
(1) narrowing of second and third order biliary branches
(2) ductopenia involving second and third order biliary branches
(3) irregularities in the contours of the major bile ducts
