Biliary Cast Syndrome Following Liver Transplantation: A Challenging Case

Mahek Shah, Ritika Puri, Obiora Maludum, Soumya Patnaik, Marvin Lu


Biliary cast syndrome (BCS) complicates up to one in six patients post-orthotopic liver transplant (OLT). Management of BCS is challenging with limited success using endoscopic retrograde cholangiopancreatography (ERCP) or open exploration to clear the casts with some patients requiring re-transplantation. We present a case of BCS in a patient who suffered from vascular complications at the time of OLT rendering him a non-candidate for repeat liver transplantation in addition to increasing risk for ischemic insult and biliary strictures, and the challenges faced in his care.

J Med Cases. 2016;7(5):158-160


Biliary cast; Cirrhosis; Sludge; Bilioma; Duct dilation; Liver transplant

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