People who abuse ketamine may develop liver disease associated with excretion of metabolites in the bile.
Clinical presentation:
(1) abdominal pain
(2) nausea and vomiting
(3) jaundice
Laboratory findings - abnormal liver function tests with cholangitic pattern:
(1) elevated serum total bilirubin
(2) elevated serum alkaline phosphatase
(3) elevated serum ALT
Pathologic findings:
(1) cholangiopathy with dilatation of the bile ducts with or without choledochal cysts
(2) bridging fibrosis in the liver
Imaging studies are negative for duct obstruction or external compression.
Differential diagnosis:
(1) other biliary tract disorders
(2) other drug-induced liver disease
(3) infectious hepatitis
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Specialty: Gastroenterology, Pharmacology, clinical
