Infectious cholangitis


 * Sources of infection – hematogenously via the liver parenchyma, from the diseased gallbladder, ascending through the papilla,
 * most often accompanied by pathological conditions in the bile ducts – cholelithiasis, bile duct stenosis…,
 * Sometimes complications of diagnostic manipulations in the bile pathways (ERCP),
 * agents – E.coli, pseudomonas, aerobacter, enterococcus, streptococcus a stafylococcus,
 * patologically – all formsof inflammation.

Clinical picture

 * The so called Charcot Triad:
 * septic fever with chills (intermitentní),
 * obstructuve jaundice,
 * pressure pain in the right abdomen,
 * it is always a severe septic disease, it should be treated with broad-spectrum ATB - prevention of sepsis, they get directly into the bile ducts minimally,
 * We must monitor the patient and, if the condition does not improve quickly, revise the bile ducts surgically, remove the obstruction in the outflow.

Diagnosis

 * According to the image, especially when there is a history of stenosis or liathiases,
 * we usually find an enlarged and painful liver, or and spleen,
 * Leukocytosis, high sedimentation, liver tests,
 * a persistent condition with occasional flare-up may result in chronic inflammation and later in biliary cirrhosis of the liver.

Therapy

 * Diagnosis and elimination of the cause of bile stasis, ATB administration and bile duct drainage.

Related articles

 * Primary sclerosing cholangitis
 * Acute cholecystitis
 * Chronic cholecystitis
 * Cholelithiasis