Primary Sclerosing Cholangitis
Diagnosis

Your doctor will first ask you about your medical history, which can suggest a likelihood of primary sclerosing cholangitis (PSC), especially if there is a history of inflammatory bowel disease and abnormal blood test results.

PSC is diagnosed through a procedure called cholangiography, which involves injecting dye into the bile ducts and taking an X-ray. Cholangiography can be performed as an endoscopic procedure, called endoscopic retrograde cholangiopancreatography (ERCP), through radiology or surgery, or with magnetic resonance imaging (MRI) scans. Cholangiography is performed under sedation. A lighted, flexible endoscope is inserted through the mouth, stomach and then into the small intestine. A thin tube is place through the scope into the bile ducts and dye is injected to highlight the bile ducts on the X-ray. If there is a narrowing of the bile ducts, the diagnosis of PSC is confirmed.

As the disease progresses, a liver biopsy is usually needed to confirm PSC, and determine how much damage has occurred. Under local anesthesia, a slender needle is inserted through the right lower chest to extract a small piece of liver for microscopic analysis.