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:
  1. septic fever with chills (intermitentní),
  2. obstructuve jaundice,
  3. 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.

Links

Related articles

• Primary sclerosing cholangitis
• Acute cholecystitis
• Chronic cholecystitis
• Cholelithiasis

Source

Kategorie:Vložené články Kategorie:Chirurgie Kategorie:Vnitřní lékařství Kategorie:Gastroenterologie Kategorie:Patologie