Cholangitis (patient information)

Cholangitis
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Cholangitis?
Prevention
What to expect (Outlook/Prognosis)?
Cholangitis On the Web
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Meagan E. Doherty

Overview

Cholangitis is an infection of the common bile duct, the tube that carries bile from the liver to the gallbladder and intestines. Bile is a chemical made by the liver that helps digest food.

What are the symptoms of Cholangitis?

The following symptoms may occur:

• Abdominal pain

• In the right upper side or middle of the upper abdomen
• May come and go
• Pain is sharp, crampy, or dull
• Pain may move the back or below the right shoulder blade

• Fever and chills
• Clay-colored stools
• Dark urine
• Nausea and vomiting
• Yellowing of the skin (jaundice) -- may come and go

What causes Cholangitis?

Cholangitis is usually caused by a bacterial infection, which can occur when the duct is blocked by something, such as a gallstone or tumor. The infection causing this condition may also spread to the liver.

Who is at highest risk?

Risk factors include:

• Previous history of gallstones
• Sclerosing cholangitis
• HIV
• Narrowing of the common bile duct
• Traveling to countries where you might catch a worm or parasite infection

Diagnosis

Tests for Cholangitis may include:

• Abdominal ultrasound
• Endoscopic retrograde cholangiopancreatography (ERCP): ERCP uses an endoscope—a long, flexible, lighted tube—that goes down the mouth, beyond the stomach, and into the duodenum to reach an area in the digestive tract where dye can be injected into the bile ducts. X rays are taken when the dye is injected. ERCP also can be used to take a tissue sample or to treat blocked ducts.
• Magnetic resonance cholangiopancreatography (MRCP): MRCP uses magnetic resonance imaging (MRI) to obtain pictures of the bile ducts. MRI machines use radio waves and magnets to scan internal organs and tissues. MRCP does not involve using x rays or inserting instruments into the body. This safe and painless test is increasingly used for diagnosis.
• Percutaneous transhepatic cholangiogram (PTCA): This procedure involves inserting a needle through the skin and placing a thin tube into a duct in the liver. Dye is injected through the tube and x rays are taken.

The following blood tests may be done to test for cholangitis:

• Bilirubin level
• Liver enzyme levels
• Liver function tests
• White blood count (WBC)

Diseases with similar symptoms

• Pancreatic cancer
• Common bile duct cancer
• Acute hepatitis
• Biliary stricture
• Cholestatic liver disease
• Cirrhosis
• Pancreatitis

When to seek urgent medical care?

Call for an appointment with your health care provider if you have symptoms of cholangitis.

Treatment options

Quick diagnosis and treatment are very important.

Antibiotics to cure infection are tried first for most patients. ERCP or other surgical procedures are done when the patient is stable.

Patients who are very ill or are quickly getting worse may need surgery right away.

Where to find medical care for Cholangitis?

Directions to Hospitals Treating Cholangitis

Prevention of Cholangitis

Treatment of gallstones, tumors, and infestations of parasites may reduce the risk for some people. A metal or plastic stents within the bile system may be needed to prevent recurrence.

What to expect (Outlook/Prognosis)?

The outcome is usually good with treatment, but poor without it.

Sources

• http://www.nlm.nih.gov/medlineplus/ency/article/000290.htm
• http://digestive.niddk.nih.gov/ddiseases/pubs/primarysclerosingcholangitis/