Cholestatic liver disease. Recognizing the clinical signs.

Cholestatic liver disease in women is most often seen as primary biliary cirrhosis, an autoimmune disease that may take many years to cause symptoms and is often a challenge for physicians to identify. Primary sclerosing cholangitis is a cholestatic liver disease with a more straightforward presentation. Most commonly seen in men, this disease may rapidly progress to cirrhosis or to a third common cholestatic disease, cholangiocarcinoma. In this article, Drs Bhatia and Mihas discuss the etiologic and diagnostic features of these entities and explore medical, surgical, and palliative treatment approaches. In all three diseases, liver transplantation is a viable, life-extending therapeutic option.