Certain conditions may interfere with the blood supply to the bile ducts, resulting in ischemic cholangiopathy.


Hypercoagulable state:

(1) antiphospholipid syndrome

(2) paroxysmal nocturnal hemoglobinuria (PNH)



(1) polyarteritis nodosa

(2) systemic lupus erythematosus

(3) Henoch-Schonlein purpura

(4) other


Intravascular event:

(1) cholesterol crystal embolism

(2) interventional radiology involving the hepatic artery

(3) infusion of a toxic chemical into the hepatic artery, including chemotherapeutic agents

(4) sickle cell anemia

(5) severe atherosclerosis


Infection related:

(1) Kawasaki disease

(2) cholangiopathy associated with septic shock

(3) AIDS-related cholangiopathy



(1) liver transplant

(2) postcholecystectomy stricture



(1) hypereosinophilia syndrome

(2) radiation field that includes the biliary system

(3) hereditary hemorrhagic telangiectasia (HHT, due to blood diverted through vascular shunts)

(4) arterial compression due to tumor or abscess


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