Cholangitis causes: Difference between revisions
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Revision as of 14:09, 25 October 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
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Cholangitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Cholangitis causes On the Web |
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American Roentgen Ray Society Images of Cholangitis causes |
Overview
Cholangitis is usually caused by a bacterial infection, which can occur when there is blockage in the bile duct, such as a gallstone or tumor. The infection causing this condition may also spread to the liver.
Causes
Common Causes
The most common causes of biliary obstruction are biliary calculi, benign stricture, and malignant neoplasms. Benign strictures are caused by primary sclerosing cholangitis, ischemic cholangitis, iatrogenic biliary tract injury, congenital disease, and infection. Chronic inflammation predisposes one to the development of cholangiocarcinoma. Extraluminal obstruction can occur from pancreatic cancer or pseudocyst, lymphoma, hepatoma, metastatic disease or ampullary cancer. Any condition in the CBD that leads to stasis, including benign or malignant stricture, parasitic infection, or extrinsic compression by the pancreas can result in bacterial infection and cholangitis. There is a higher rate of infection due to partial obstruction of the CBD compared to a complete obstruction.[1]
Other Causes
Bile duct obstructions are generally due to gallstones. 10-30% of cases are due to other causes, including:[1]
- Postoperative damage or altered structure of bile duct, such as narrowing at site of an anastomosis
- Various tumors (cancer of the bile duct, gallbladder, ampulla of Vater, pancreas, or duodenum)
- Presence of anaerobic organisms such as Clostridium or Bacteroides
Parasites can infect the liver and bile ducts, which can also cause cholangitis. These include:[2]
- Roundworm (Ascaris lumbricoides)
- Liver flukes (Clonorchis sinensis)
- Opisthorchis viverrini
- Opisthorchis felineus
In people with AIDS, a large number of opportunistic organisms has been known to cause AIDS cholangiopathy. The risk has rapidly diminished since the introduction of effective AIDS treatment.[1][3]
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical/Poisoning | No underlying causes |
| Dental | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Cidofovir, Sorafenib, Teduglutide |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | Cholelithiasis, Biliary stricture |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | Escherichia coli, Klebsiella, Enterococcus, Enterobacter, Bacteroides, Clostridia |
| Musculoskeletal/Orthopedic | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional/Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Ophthalmologic | No underlying causes |
| Overdose/Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal/Electrolyte | No underlying causes |
| Rheumatology/Immunology/Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
References
- ↑ 1.0 1.1 1.2 Kinney TP (2007). "Management of ascending cholangitis". Gastrointest. Endosc. Clin. N. Am. 17 (2): 289–306, vi. doi:10.1016/j.giec.2007.03.006. PMID 17556149.
- ↑ Lim JH (2011). "Liver flukes: the malady neglected". Korean J Radiol. 12 (3): 269–79. doi:10.3348/kjr.2011.12.3.269. PMC 3088844. PMID 21603286.
- ↑ Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR (2007). "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 15–26. doi:10.1007/s00534-006-1152-y. PMC 2784509. PMID 17252293.