The Cloaked Intruder: An Unexpected Case of Eosinophilic Cholangitis

Abstract

Often, when biliary strictures are evaluated, malignancy is high on the differential. However, it is important to consider benign and malignant causes because approximately 10% of biliary strictures are benign. Eosinophilic cholangitis is an extremely rare benign disorder of the biliary tract caused by fibrosis and stricture from eosinophilic infiltration. The etiology of the disease remains unclear, and often, patients present with obstructive jaundice. We present a young man who presented with obstructive jaundice and abdominal pain, with a biliary stricture and peripheral eosinophilia. The final surgical pathology revealed eosinophilic cholangitis.

Eosinophilic Cholangitis with Poor Prognosis after Corticosteroid- and Ursodeoxycholic Acid-Related Remission of Peripheral and Peribiliary Eosinophilia

“…The range of the lesions in EC varies from case to case; some patients present only focal changes of biliary tree, while others experience complications in form of cholecystitis and widespread biliary stenoses [ 13 ]. EC may be a diagnostic challenge, especially in patients without peripheral eosinophilia who present biliary stricture mimicking neoplastic biliary obstruction [ 14 , 15 , 16 , 17 , 18 ].…”