• Grace Lai-Hung Wong, Yuk-Him Tam, Chi-Fai Ng, Anthony Wing-Hung Chan, Paul Cheung-Lung Choi, Winnie Chiu-Wing Chu, Paul Bo-San Lai, Henry Lik-Yuen Chan, and Vincent Wai-Sun Wong.
• Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong; Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.
• Clin. Gastroenterol. Hepatol. 2014 Oct 1;12(10):1759-62.e1.

AbstractAbuse of ketamine leads to liver injury. We investigated the histopathologic and radiologic features of ketamine abusers with significant liver injury in a cross-sectional survey of 297 consecutive chronic abusers of ketamine with urinary tract dysfunction. Liver biopsy and magnetic resonance cholangiopancreatography were performed in patients with liver injury (concentrations of bilirubin, alkaline phosphatase, and/or alanine aminotransferase >2-fold the upper limit of normal). The prevalence of liver injury was 9.8% (all cases cholestatic). Bile duct injury was observed in all 7 patients assessed by liver biopsy. Two patients had bridging fibrosis despite their young age. Three of 6 patients who underwent magnetic resonance cholangiopancreatography examination were found to have prominent or dilated common bile ducts without obstructions or extrinsic compressions. Ketamine abuse therefore appears to lead to common bile duct dilatation, microscopic bile duct injury, and even significant liver fibrosis.Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

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