Cholangitis causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farwa Haideri [2]
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Overview
Cholangitis is commonly caused by bacterial infections, which can occur when the common bile duct (CBD) is obstructed.
Causes
Common Causes
The most common causes of biliary obstruction are biliary calculi, benign stricture or malignant neoplasms. Benign strictures are caused by primary sclerosing cholangitis, ischemic cholangitis, iatrogenic biliary tract injury, congenital disease and infection. Chronic inflammation predisposed 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, such as:[2]
- Benign stricture: narrowing of the bile duct without an underlying tumor
- 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).
- Anaerobic organisms such as Clostridium and 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.[2]
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 | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | No underlying causes |
| 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
- ↑ Acute Cholangitis Clinical Presentation. MedScape (2016). http://emedicine.medscape.com/article/774245-clinical#b5 Accessed on April 1, 2016
- ↑ 2.0 2.1 2.2 Cholangitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Ascending_cholangitis#Causes Accessed on April 1, 2016