Diagnosis Gastroenterology

Primary Sclerosing Cholangitis

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.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.