case_images: PMC5421083_01
case_images: Black esophagus on endoscopy.
case_images: CRIM2017-8362613.001.jpg
case_images: PMC5421083_01_CRIM2017-8362613.001.jpg
case_images: fig1
case_images: There were no varices, ulcerations, or other causes of bleeding (Figure 1).
case_images: Endoscopic Retrograde Cholangiopancreaticogram showing sclerosing cholangitis.
case_images: CRIM2017-8362613.002.jpg
case_images: PMC5421083_01_CRIM2017-8362613.002.jpg
case_images: fig2
case_images: ERCP showed cholelithiasis and choledocholithiasis and balloon occlusion cholangiogram suggested sclerosing cholangitis (Figure 2).
case_images: Endoscopic visualization of necrotic biliary cast.
case_images: CRIM2017-8362613.003.jpg
case_images: PMC5421083_01_CRIM2017-8362613.003.jpg
case_images: fig3
case_images: ERCP confirmed secondary sclerosing cholangitis and several biliary casts could be extracted by balloon sweeping of the biliary tree (Figure 3). Eight months after presentation he developed large volume ascites treated with diuretics.