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Digestive system
Digestive system
Bile pathway
Bile pathway

Cholangitis
Definition:
Cholangitis is an infection of the common bile duct, which carries bile (which helps in digestion) from the liver to the gallbladder and then to the intestines.

Causes, incidence, and risk factors:

Cholangitis is usually caused by a bacterial infection, which can occur when the duct is obstructed by a gallstone; stricture, or tumor. Flukes and worms can sometimes become lodged in the bile duct and lead to this problem, but this is not common in the United States.

The infection causing this condition can also spread to the liver. Risk factors are a previous history of gallstones, biliary diseases such as sclerosing cholangitis (primary or secondary), HIV, and rarely, travel to countries where a worm or fluke infection can be contracted.
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)
  • dark urine (may occur)
  • nausea
  • vomiting
Signs and tests:

Tests that show obstruction or infection of the bile duct:

Blood tests that may be affected include:
Treatment:
Antibiotic therapy can eliminate the infection. Obstructed bile ducts may be drained by ERCP or by PTCA. Flukes and worms can be eliminated with appropriate medications.
Expectations (prognosis):
The outcome is usually good with treatment, but poor without it.
Complications:
Calling your health care provider:

Call for an appointment with your health care provider if symptoms suggestive of cholangitis develop.

Call your health care provider if cholangitis symptoms worsen or do not improve with treatment, or if new symptoms develop.
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.
Review Date: 10/27/2002
Reviewed By: Jenifer K. Lehrer, M.D., Department of Gastroenterology, Graduate Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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