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Cholangitis is an infection of the bile duct caused by an obstruction or infection. Symptoms include pain, fever, and low blood pressure. Diagnostic tests include blood tests and imaging. Treatment involves antibiotics, blood pressure management, and possibly surgery. Risk factors include age and a history of gallstones.
Cholangitis is an infection of the bile duct, the channel that carries bile from the gallbladder and liver to the duodenum of the small intestine to help digest food. An obstruction due to the presence of something such as a stone, tumor or blood clot within the bile duct system is usually the main cause of the disease. Other possible causes include a blood infection or bacteremia, bacteria from the small intestine, or a diagnostic test such as endoscopy. Some of the symptoms of this disorder are pain in the right upper quadrant of the abdomen, fever and low blood pressure.
Cholangiohepatitis, primary sclerosing cholangitis (PSC), and ascending cholangitis are some of the types of this infection. In cholangiohepatitis, a person experiences repeated bouts of cholangitis. This is combined with intrahepatic biliary obstruction and intrahepatic pigment stones. ‘Intrahepatic’ means that they affect structures within the liver.
In PSC, swelling of the bile ducts is progressive. This can lead to blockage and damage to the bile ducts inside and outside the liver. A person suffering from ascending cholangitis experiences infection of the bile duct due to bacteria that rises up from where it intersects with the duodenum. You will probably have jaundice, pain in the abdominal area or fever.
A person with symptoms of cholangitis will likely need to undergo some diagnostic tests. You may need blood tests including a blood culture to check for infection, a test to determine if there is liver dysfunction, and a complete blood count. You may also be asked to undergo imaging tests such as endoscopic retrograde cholangiopancreatography (ERCP), cholangiography, or percutaneous transhepatic cholangiography (PTC).
The results of these tests can help a doctor recognize blockage in the bile duct system and determine the course of treatment. The medical case management of a person with cholangitis generally depends on their medical history and the complexity of their disease. Treatment of the disease typically involves the administration of antibiotics through an intravenous (IV) line, returning blood pressure to normal levels if it is low, and possibly surgery if there is a blockage in the bile duct system.
Generally, a person in their 50s is at risk of getting cholangitis. A person who has had gallstones, on the other hand, is at a higher risk of getting the disease. It is advisable for a person who is considered at risk to visit a doctor regularly for a checkup.
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