A 50year old male presents with pain upper abdomen, Pruritus, jaundice and weight loss, elevated ANA, the likely diagnosis is: (A) Primary sclerosing cholangitis, (B) Klatskin tumor, (C) Secondary sclerosing cholangitis, (D) Choledocholithiasis
Answer is A. Clinical features More common in males, mean age at presentation is 40-45 years. About 75% of patients are symptomatic at presentation with evidence of cholestatic liver disease such as jaundice, Pruritus and fatigue Symptoms of bacterial cholangitis are uncommon. Condition is characterized by relapses & remissions with quiescent periods. Median survival from the time of diagnosis ranges from 10 to 12 years Ref: Sabiston 20th edition Pgno : 1508-1509