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Cholangitis

 

Cholangitis is an infection of the bile ducts, the tubes that carry bile from the liver to the gallbladder and intestines. Bile is a liquid made by the liver that helps digest food.

Causes

Cholangitis is most often caused by bacteria. This can occur when the duct is blocked by something, such as a gallstone or tumor. The infection causing this condition may also spread to the liver.

Risk factors include a previous history of gallstones, sclerosing cholangitis, HIV, narrowing of the common bile duct, and rarely, travel to countries where you might catch a worm or parasite infection.

Symptoms

 

The following symptoms may occur:

  • Pain on the upper right side or upper middle part of the abdomen. It may also be felt in the back or below the right shoulder blade. The pain may come and go and feel sharp, cramp-like, or dull.
  • Fever and chills.
  • Dark urine and clay-colored stools.
  • Nausea and vomiting.
  • Yellowing of the skin (jaundice), which may come and go.

 

Exams and Tests

 

You may have the following tests to look for blockages:

  • Abdominal ultrasound
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Percutaneous transhepatic cholangiogram (PTCA)

You may also have the following blood tests:

  • Bilirubin level
  • Liver enzyme levels
  • Liver function tests
  • White blood count (WBC)

 

Treatment

 

Quick diagnosis and treatment are very important.

Antibiotics to cure infection are the first treatment done in most cases. ERCP or other surgical procedure is done when the person is stable.

People who are very ill or are quickly getting worse may need surgery right away.

 

Outlook (Prognosis)

 

The outcome is very often good with treatment, but poor without it.

 

Possible Complications

 

Complications may include:

  • Sepsis

 

When to Contact a Medical Professional

 

Call your health care provider if you have symptoms of cholangitis.

 

Prevention

 

Treatment of gallstones, tumors, and infestations of parasites may reduce the risk for some people. A metal or plastic stent that is placed in the bile system may be needed to prevent the infection from returning.

 

 

References

Anstee QM, Jones DEJ. Liver and biliary tract disease. In: Walker BR, Colledge NR, Ralston SH, Perman ID, eds. Davidson's Principles and Practice of Medicine. 22nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2012:chap 23.

Fogel EL, Sherman S. Diseases of the gallbladder and liver. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 155.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Bile pathway

    Bile pathway - illustration

    The biliary system is comprised of the organs and duct system that create, transport, store and release bile into the duodenum for digestion. Includes the liver, gallbladder and bile ducts (named the cystic, hepatic, common, and pancreatic duct).

    Bile pathway

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Bile pathway

      Bile pathway - illustration

      The biliary system is comprised of the organs and duct system that create, transport, store and release bile into the duodenum for digestion. Includes the liver, gallbladder and bile ducts (named the cystic, hepatic, common, and pancreatic duct).

      Bile pathway

      illustration

    A Closer Look

     

      Tests for Cholangitis

       

         

        Review Date: 5/11/2016

        Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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