ASCENDING CHOLANGITIS

• Acute cholangitis is an ascending bacterial infection of the biliary tree caused by an obstruction characterised by inflammation of bile ducts.

 

 

ETIOLOGY-

• Choledocholithiasis (MC)
• Biliary stricture
• Choledochal cyst
• Cholangiocarcinoma
• MC organism – E. Coli > Klebsiella
• Associated with HLA A1, B8 and DR3

CLINICAL FEATURES-

• Septicaemia
• Charcott’s Triad- fever, jaundice and right upper quadrant pain
• Reynold’s pentad- mental status changes and hypotension join charcot triad
• More common in males

 

 

INVESTIGATIONS-

1. Ultrasound- for intra and extrahepatic dilation
2. CT- inflammation and thickness of bile ducts
3. MRCP- non invasive investigation.
4. Direct cholangiography- invasive

 

 

TREATMENT-

1. Endoscopic biliary decompression
2. Percutaneous transhepatic duct

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