A Case Report of Seuretin Therapy for Primary Sclerosing Cholangitis

Primary sclerosing cholangitis (PSC) is a liver disease which is characterized by fibrous stenosis of both intra- and extra-hepatic bile ducts. No definite therapy has been established yet and the prognosis is very poor. The patient had persistent jaundice for about five years and levels of the serum total bilirubin fluctuated from 14.2 to 33.4mg/dl (mean value 20.1mg/dl). In order to improve jaundice, secretin, one of gut hormones, was administered intravenously in a dose of 150 to 200 units. As a result, the serum bilirubin was significantly decreased for about 8 months as compared to levels one year before secretin administration. It seemed that secretin was effective to improve the prognosis. Secretin therapy for PSC is entirely new strategy and appears to be useful as a medical treatment before induction of curative therapy such as liver transplantation.

Brainstem

Ischemia

Recirculation

Hyperperfusion

Vasomotor center