Cholangitis
Definition
An infectious inflammation of the common bile duct.
Causes
and risks
A bacterial infection in the bile duct and
its bile is the usual cause of cholangitis.
Bacterial infection is caused by obstruction
of the duct by a gallstone; stricture or tumor;
or in some parts of the world, by a fluke or
a worm.
The infection may spread to the liver. The risk
factor is a previous history of cholelithiasis
(gallstones), biliary diseases such as sclerosing
cholangitis (primary or secondary), and HIV.
Cholangitis occurs in approximately 1 out of
10,000 people.
Prevention
Treatment of gallstones,
tumors, and infestations (flukes and worms) may
reduce the risk for some people. The placement
of metal or plastic stents within the bile system
may be necessary to prevent recurrence.
Symptoms
- recurrent jaundice
- abdominal pain
- in the right upper quadrant or middle
of the upper abdomen
- may be recurrent
- sharp or cramping or dull
- may radiate to the back or below the
right shoulder blade
- chills
- fever
- stools, clay colored (may occur)
Signs
and tests
Tests that show obstruction or infection of
the bile duct:
- ERCP (endoscopic retrograde cholangiopancreatography)
examines the biliary (liver secretion) system
and the pancreatic duct
- percutaneous transhepatic cholangiogram
(PTCA)
- abdominal ultrasound
- MRCP (magnetic resonance cholangiopancreatography)
Blood tests that may be affected include:
- liver function tests
- bilirubin levels, abnormal
- WBC, increased
Treatment
Antibiotic therapy can eliminate
the infection. Obstructed bile ducts may be drained
by endoscopy (ERCP) or by percutaneous transhepatic
cholangiogram (PTCA).
Prognosis
The outcome is usually good
with treatment, but poor without it. |
