Prevalence of inflammatory bowel disease among patients with primary sclerosing cholangitis in Iran

Background and study aims: In Iran, the epidemiology of primary sclerosing cholangitis [PSC] and its association with inflammatory bowel disease [IBD] have not been studied thoroughly. This study investigates the epidemiology and prevalence of IBD among patients with PSC

Patients and methods: A retrospective study of 154 patients with PSC was conducted. The demographic and clinical data were collected, and the variables were analysed in the following two patient groups: patients with both PSC and IBD, and patients with PSC and without IBD

Results: A total of 154 patients with a mean age of 40.3 years [range 20-81 years] were included, of whom 57 [37%] were female and 97 [63%] male. Ninety-six patients [62.3%] were diagnosed with IBD, 92 [59.7%] with ulcerative colitis, and four [2.6%] with Crohn's disease. In this study, elevated alkaline phosphatase levels were found in 90.8% of patients. The intra-hepatic duct [IHD] and extrahepatic duct [EHD] were involved in 70.5% of patients, isolated intrahepatic bile duct in 24.4%, and isolated extrahepatic duct in 3.8%. Small-duct PSC [normal results of imaging and PSC proved by histology of liver biopsy] was observed only in 1.3% of patients

Conclusion: PSC has become increasingly diagnosed in Iran. This is possibly because of better diagnostics and the increasing prevalence of IBD in this country. For diagnosing PSC and identifying the presence of IHD strictures, the results of both magnetic resonance cholangiopancreatography [MRCP] and endoscopic retrograde cholangiopancreatography [ERCP] showed good interobserver agreement, but the ERCP results could be used to evaluate the presence and severity of EHD strictures

patient with cystic lymphangioma in pancreas

Cystic lymphangioma of the pancreas is extremely rare, accounting for less than 1% of pancreatic tumors. Though congenital, it can affect all age groups. Cystic lympangioma occurs more frequently in females. Patients usually present with epigastric pain and an associated palpable epigastric mass. Complete excision is curative, even though, depending on the tumor location, surgery may be simple or involve extensive pancreatic resection and anastomoses. In this case report, we discuss a 63 -year old patient who presented with epigastric pain and on investigation was found to have pancreatic head cystic lymphangioma. At surgery the tumor was completely excised, with preservation of pancreatic duct. Histology and immunohistochemistry confirmed cystic lymphangioma of the pancreas. This case highlights that a diagnosis of cystic lymphangioma of the pancreas should be taken into consideration as a differential diagnosis of pancreatic cystic lesions