What condition is suggested by a "beaded appearance" on ERCP?

The "beaded appearance" observed on Endoscopic Retrograde Cholangiopancreatography (ERCP) is characteristic of Primary Sclerosing Cholangitis (PSC). This condition is a chronic liver disease that is associated with progressive inflammation and scarring of the bile ducts. As the bile ducts become damaged, they can develop strictures and dilatations, which create a beaded pattern that becomes evident on imaging studies like ERCP.

PSC often presents in conjunction with inflammatory bowel disease (IBD), particularly ulcerative colitis, making its diagnosis significant in the context of these gastrointestinal conditions. The beaded appearance is not just a marker of damage but also indicates the underlying inflammation and complicating factors associated with the disease, showcasing the alterations in the biliary tree that occur due to the scarring and strictures.

The other conditions listed do not manifest with a beaded appearance on ERCP. For instance, cholecystitis primarily affects the gallbladder and would not typically reveal the characteristic bile duct changes seen in PSC. Pseudocysts of the pancreas are associated with pancreatic inflammation and do not present as a beaded appearance on bile duct imaging. Hepatocellular carcinoma is a primary liver cancer that would usually show mass