22nd April 2024

A 37-year-old female is reviewed in the inflammatory bowel disease clinic

A 37-year-old female is reviewed in the inflammatory bowel disease clinic. She takes mesalazine and azathioprine for Ulcerative Colitis (UC) and reports that, from a bowel perspective, her symptoms have been well controlled. However, over the past few weeks, she has been feeling increasingly tired and has noticed a new itch. There is no history of fevers or weight loss. On examination, her sclera are slightly jaundiced and there are scratch marks on her skin. You organise some urgent bloods and arrange an urgent MRCP.

Bloods show the following:

MRCP showed evidence of multiple segmental strictures throughout the biliary tree. It also comments on a few incidental gallstones contained within the gallbladder. Which of the following is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.