Ascending cholangitis: Difference between revisions
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{{Infobox medical condition | |||
| name = Ascending cholangitis | |||
| image = [[File:Cholangitis.jpg|alt=Cholangitis]] | |||
| caption = [[Endoscopic retrograde cholangiopancreatography]] (ERCP) image showing bile duct stones causing cholangitis | |||
| synonyms = Acute cholangitis, [[biliary tract infection]] | |||
| pronounce = | |||
| specialty = [[Gastroenterology]], [[Hepatology]] | |||
| symptoms = [[Fever]], [[jaundice]], [[abdominal pain]] | |||
| complications = [[Sepsis]], [[liver abscess]], [[biliary cirrhosis]] | |||
| onset = Sudden | |||
| duration = | |||
| types = | |||
| causes = [[Bile duct obstruction]] (e.g., [[gallstones]], [[stricture]], [[tumor]]) | |||
| risks = [[Choledocholithiasis]], [[biliary stricture]], [[pancreatic cancer]] | |||
| diagnosis = [[Blood culture]], [[liver function tests]], [[ultrasound]], [[ERCP]] | |||
| differential = [[Cholecystitis]], [[hepatitis]], [[pancreatitis]] | |||
| prevention = | |||
| treatment = [[Antibiotics]], [[ERCP]], [[surgery]] | |||
| medication = [[Ciprofloxacin]], [[metronidazole]], [[piperacillin/tazobactam]] | |||
| prognosis = | |||
| frequency = | |||
| deaths = | |||
}} | |||
= Ascending Cholangitis = | = Ascending Cholangitis = | ||
== Introduction == | == Introduction == | ||
'''Ascending Cholangitis''', also known as '''acute cholangitis''', is a serious infection of the bile ducts characterized by the presence of bacteria ascending from the small intestine into the biliary system. This condition is a medical emergency that requires prompt diagnosis and treatment to prevent complications such as sepsis and liver damage. | '''Ascending Cholangitis''', also known as '''acute cholangitis''', is a serious infection of the bile ducts characterized by the presence of bacteria ascending from the small intestine into the biliary system. This condition is a medical emergency that requires prompt diagnosis and treatment to prevent complications such as sepsis and liver damage. | ||
[[File:Gallstones and Ascending Cholangitis.jpg|left|thumb|Diagram of the Gallstones and Ascending Cholangitis and biliary system showing the location of the bile ducts.]] | |||
[[File:Gallstones and Ascending Cholangitis.jpg|thumb|Diagram of the Gallstones and Ascending Cholangitis and biliary system showing the location of the bile ducts.]] | |||
== Causes == | == Causes == | ||
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Ascending cholangitis is most commonly caused by bacterial infection. The primary risk factor for developing this condition is bile duct obstruction, which can occur due to: | Ascending cholangitis is most commonly caused by bacterial infection. The primary risk factor for developing this condition is bile duct obstruction, which can occur due to: | ||
* Gallstones | * Gallstones | ||
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* Biliary tract surgeries | * Biliary tract surgeries | ||
* Tumors | * Tumors | ||
[[File:Asc cholang c1 2016 06 22.tif|left|thumb|microscopic image showing gallstones in the bile duct, a common cause of cholangitis.]] | |||
[[File:Asc cholang c1 2016 06 22.tif|thumb|microscopic image showing gallstones in the bile duct, a common cause of cholangitis.]] | |||
== Pathophysiology == | == Pathophysiology == | ||
The pathophysiology of ascending cholangitis involves the obstruction of bile flow, leading to increased pressure in the bile ducts and bacterial overgrowth. The bacteria typically ascend from the small intestine, taking advantage of the disrupted bile flow to infect the biliary tract. | The pathophysiology of ascending cholangitis involves the obstruction of bile flow, leading to increased pressure in the bile ducts and bacterial overgrowth. The bacteria typically ascend from the small intestine, taking advantage of the disrupted bile flow to infect the biliary tract. | ||
== Symptoms == | == Symptoms == | ||
Symptoms of ascending cholangitis can include: | Symptoms of ascending cholangitis can include: | ||
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* Nausea and vomiting | * Nausea and vomiting | ||
* Malaise | * Malaise | ||
== Diagnosis == | == Diagnosis == | ||
Diagnosis of ascending cholangitis is based on clinical presentation, laboratory tests, and imaging studies. Key diagnostic tools include: | Diagnosis of ascending cholangitis is based on clinical presentation, laboratory tests, and imaging studies. Key diagnostic tools include: | ||
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* Ultrasound or MRCP (Magnetic Resonance Cholangiopancreatography) to visualize obstructions in the bile ducts | * Ultrasound or MRCP (Magnetic Resonance Cholangiopancreatography) to visualize obstructions in the bile ducts | ||
* ERCP (Endoscopic Retrograde Cholangiopancreatography) for both diagnosis and treatment | * ERCP (Endoscopic Retrograde Cholangiopancreatography) for both diagnosis and treatment | ||
== Treatment == | == Treatment == | ||
Treatment for ascending cholangitis typically involves: | Treatment for ascending cholangitis typically involves: | ||
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* Relief of bile duct obstruction, which may require procedures such as ERCP or surgery | * Relief of bile duct obstruction, which may require procedures such as ERCP or surgery | ||
* Supportive care for symptoms and to prevent complications | * Supportive care for symptoms and to prevent complications | ||
== Prognosis == | == Prognosis == | ||
With prompt and appropriate treatment, the prognosis for ascending cholangitis can be good. However, the condition can be life-threatening if not treated promptly, emphasizing the importance of early detection and intervention. | With prompt and appropriate treatment, the prognosis for ascending cholangitis can be good. However, the condition can be life-threatening if not treated promptly, emphasizing the importance of early detection and intervention. | ||
== See Also == | == See Also == | ||
* [[Bile duct]] | * [[Bile duct]] | ||
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* [[Gallstones]] | * [[Gallstones]] | ||
* [[ERCP]] | * [[ERCP]] | ||
== References == | == References == | ||
* "Hepatology: A Textbook of Liver Disease." David Zakim and Thomas D. Boyer, 2012. | * "Hepatology: A Textbook of Liver Disease." David Zakim and Thomas D. Boyer, 2012. | ||
* "Oxford Textbook of Medicine." Warrell, Cox, Firth, and Benz, 2010. | * "Oxford Textbook of Medicine." Warrell, Cox, Firth, and Benz, 2010. | ||
== External Links == | == External Links == | ||
* [https://www.uptodate.com/contents/acute-cholangitis UpToDate: Acute Cholangitis] | * [https://www.uptodate.com/contents/acute-cholangitis UpToDate: Acute Cholangitis] | ||
* [https://www.gastro.org/practice-guidance/guidelines American Gastroenterological Association Guidelines] | * [https://www.gastro.org/practice-guidance/guidelines American Gastroenterological Association Guidelines] | ||
{{stub}} | {{stub}} | ||
{{medicine-stub}} | {{medicine-stub}} | ||
Latest revision as of 16:57, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Ascending cholangitis | |
|---|---|
| |
| Synonyms | Acute cholangitis, biliary tract infection |
| Pronounce | |
| Specialty | Gastroenterology, Hepatology |
| Symptoms | Fever, jaundice, abdominal pain |
| Complications | Sepsis, liver abscess, biliary cirrhosis |
| Onset | Sudden |
| Duration | |
| Types | |
| Causes | Bile duct obstruction (e.g., gallstones, stricture, tumor) |
| Risks | Choledocholithiasis, biliary stricture, pancreatic cancer |
| Diagnosis | Blood culture, liver function tests, ultrasound, ERCP |
| Differential diagnosis | Cholecystitis, hepatitis, pancreatitis |
| Prevention | |
| Treatment | Antibiotics, ERCP, surgery |
| Medication | Ciprofloxacin, metronidazole, piperacillin/tazobactam |
| Prognosis | |
| Frequency | |
| Deaths | |
Ascending Cholangitis[edit]
Introduction[edit]
Ascending Cholangitis, also known as acute cholangitis, is a serious infection of the bile ducts characterized by the presence of bacteria ascending from the small intestine into the biliary system. This condition is a medical emergency that requires prompt diagnosis and treatment to prevent complications such as sepsis and liver damage.
Causes[edit]
Ascending cholangitis is most commonly caused by bacterial infection. The primary risk factor for developing this condition is bile duct obstruction, which can occur due to:
- Gallstones
- Strictures
- Biliary tract surgeries
- Tumors
Pathophysiology[edit]
The pathophysiology of ascending cholangitis involves the obstruction of bile flow, leading to increased pressure in the bile ducts and bacterial overgrowth. The bacteria typically ascend from the small intestine, taking advantage of the disrupted bile flow to infect the biliary tract.
Symptoms[edit]
Symptoms of ascending cholangitis can include:
- Fever and chills
- Jaundice
- Right upper quadrant abdominal pain
- Nausea and vomiting
- Malaise
Diagnosis[edit]
Diagnosis of ascending cholangitis is based on clinical presentation, laboratory tests, and imaging studies. Key diagnostic tools include:
- Blood tests showing elevated white blood cell count and liver enzymes
- Ultrasound or MRCP (Magnetic Resonance Cholangiopancreatography) to visualize obstructions in the bile ducts
- ERCP (Endoscopic Retrograde Cholangiopancreatography) for both diagnosis and treatment
Treatment[edit]
Treatment for ascending cholangitis typically involves:
- Antibiotics to combat the infection
- Relief of bile duct obstruction, which may require procedures such as ERCP or surgery
- Supportive care for symptoms and to prevent complications
Prognosis[edit]
With prompt and appropriate treatment, the prognosis for ascending cholangitis can be good. However, the condition can be life-threatening if not treated promptly, emphasizing the importance of early detection and intervention.
See Also[edit]
References[edit]
- "Hepatology: A Textbook of Liver Disease." David Zakim and Thomas D. Boyer, 2012.
- "Oxford Textbook of Medicine." Warrell, Cox, Firth, and Benz, 2010.
