Delbare F and Coenegrachts K
A 73-year-old man presented with epigastric pain and jaundice with a prior history of large vessel vasculitis. Elevated liver enzymes were seen on the standard blood sample. Ultrasound showed a dilated common bile duct, which required further imaging. CT scan and MRI a day later both showed an enlarged pancreatic body and tail without dilation of the pancreatic Wirsung duct and cholangitis, suggestive for auto-immune pancreatitis (AIP) with auto-immune cholangitis (AIC). The radiologist suggested the diagnosis and further steps were taken. The HISORt criteria aren’t a textbook example, but AIP with AIC is likely. Steroid therapy was initiated.
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