# Case report: Complete cast formation of the entire intrahepatic biliary tree

## TL;DR

This case report describes a rare instance of complete bile cast formation in a liver transplant patient, highlighting its diagnosis and treatment.

## Contribution

The paper presents a unique case of complete hepatic bile cast formation after a second liver transplant.

## Key findings

- A complete hepatic bile cast was observed in a patient undergoing a second liver transplant.
- The case provides insights into the anatomical and pathological features of bile cast syndrome.
- The report discusses the diagnostic and therapeutic challenges associated with this rare condition.

## Abstract

Biliary complications pose substantial challenges in liver transplantation (LT), particularly with regard to non-anastomotic strictures (NASs). Among these ischemic-type biliary complications, bile cast syndrome (BCS) is a particularly severe condition. Currently, there are limited data on the formation of complete hepatic casts in BCS. In this case report, we present a unique instance of a second LT involving the formation of a complete hepatic bile cast and discuss its diagnostic and therapeutic process. This case aims to enhance the understanding of the anatomical and pathological features of BCS.