Sonographic prediction of a normal or abnormal ERCP in suspected AIDS related sclerosing cholangitis

Aim. We have assessed the ability of ultrasound to predict an abnormal ERCP examination in patients with suspected AIDS related Sclerosing Cholangitis (ARSC). Patients and methods. The ultrasound (US) and ERCP findings of fifty patients with clinically suspected AIDS cholangiopathy were reviewed, The diagnosis was suspected due to right upper quadrant pain and cholestatic liver function tests. Results. Of the 50 patients investigated the US findings were normal in 18 (36%), Seventeen of these patients subsequently had a normal ERCP, The other patient showed changes suggestive of mile ARSC, Thirty-two (64%) patients showed a variety of abnormalities on US, Of these, 22 had typical changes of ARSC on ERCP, The remaining 10 patients also had abnormal ERCP examinations, The final diagnosis in these 10 patients included pancreatitis (5), biliary calculi (2), AIDS related lymphoma (2) and acute cholecystitis with an empyema of the gallbladder (1). Conclusion. In this study, US is 98% accurate in the prediction of a normal or abnormal ERCP examination, with a sensitivity of 97% and a specificity of 100%, This data suggests that ERCP will produce little additional information in these patients if US of the bile ducts is normal.