Cholangitis

Overview
  • Cholangitis refers to inflammation of the bile ducts which is almost always secondary to biliary obstruction and consequent bacterial infection
Pathogenesis
  • Obstruction of bile ducts can occur from a variety of conditions but is frequently due to obstruction of the common bile duct with gallstones. Upstream stasis of bile presents an opportunity for infection by bacteria of the GI tract which usually gain access to the biliary tree via the Sphincter of Oddi. Once inside the biliary tree, the infections ascend through the static bile and can reach the liver
Clinical Consequences
  • The presentation of ascending cholangitis is memorialized in "Charcot's Triad": 1) Fever, 2) Right Upper Quadrant abdominal pain, and 3) Jaundice. Patients will typically display an impressive leukocytosis and by their presentation often be bacteremic. A possible complication is the development of a liver abscess.