Acute cholangitis - an update

Abstract

Acute cholangitis is bacterial infection of the extra-hepatic biliary system. As it is caused by gallstones blocking the common bile duct in most of the cases, its prevalence is greater in ethnicities with high prevalence of gallstones. Biliary obstruction of any cause is the main predisposing factor. Diagnosis is established by the presence of clinical features, laboratory results and imaging studies. The treatment modalities include administration of intravenous fluid, antibiotics, and drainage of the bile duct. The outcome is good if the treatment is started early, otherwise it could be grave.

Keywords: Acute cholangitis; Ascending cholangitis; Biliary infection; Hepatic fever; Infection of the bile duct.

Figure 1

Pus seen extruding from the ampulla of Vater.

Figure 2

Drainage of pus after biliary stenting during endoscopic retrograde cholangiopancreatography.

Figure 3

Biliary sphincterotomy followed by stone extraction.

Figure 4

Biliary stone extraction followed by stent placement.

Figure 5

Fluoroscopy showing lithotripsy basket-assisted stone extraction.

Figure 6

Nasobiliary catheter.