A 35-year-old male presents with recurrent episodes of abdominal pain, jaundice, and fatigue and underwent MRCP. What will be the most likely diagnosis ?
To determine the most likely diagnosis for a 35-year-old male presenting with recurrent abdominal pain, jaundice, and fatigue, supplemented by an MRCP, we need to analyze the typical clinical features and diagnostic characteristics of the given options:
Primary biliary cirrhosis: Typically occurs in middle-aged women, characterized by fatigue, pruritus, and elevated alkaline phosphatase. Abdominal pain is less common, and imaging is less specific.
Caroli’s disease: A rare congenital disorder involving cystic dilatation of the bile ducts which can cause abdominal pain and jaundice, usually identified by specific radiological findings.
Primary sclerosing cholangitis: Common in young to middle-aged men, marked by progressive inflammation and scarring of bile ducts. Presents with abdominal pain, jaundice, and fatigue. MRCP often shows strictures and beading of bile ducts.
Oriental cholangitis: Also known as recurrent pyogenic cholangitis is more common in Southeast Asia, associated with bile duct strictures and stones, often presenting with similar symptoms but with geographical prevalence.
Given the age, gender, and symptomatology, coupled with the use of MRCP, which is a sensitive imaging modality for detecting bile ducts abnormalities often showing the characteristic 'beading' appearance in primary sclerosing cholangitis, the most likely diagnosis in this case is:
