cholangiti

Cholangitis is an inflammatory condition of the bile ducts, typically caused by an obstruction or infection that leads to bile stasis and subsequent bacterial growth. The term derives from the Greek words *chole* (bile) and *angitis* (inflammation of a vessel). It is most commonly associated with ascending cholangitis, where bacteria from the gastrointestinal tract ascend through the bile ducts, often due to an underlying obstruction such as gallstones (choledocholithiasis) or strictures.

Symptoms of cholangitis often include fever, jaundice (yellowing of the skin and eyes), and abdominal pain, collectively known as Charcot’s triad. If sepsis develops, additional symptoms such as hypotension and altered mental status may appear, forming Reynolds’ pentad. Diagnosis involves imaging studies like ultrasound, magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP), alongside blood tests to assess liver function and infection markers.

Treatment focuses on relieving the obstruction and addressing the infection. Broad-spectrum antibiotics are typically administered intravenously to combat bacterial overgrowth, while endoscopic or surgical interventions may be required to remove blockages. Early diagnosis and intervention are critical, as untreated cholangitis can progress to severe complications, including liver abscesses, sepsis, or even death.

Cholangitis can occur in both acute and chronic forms. Acute cholangitis is often severe and requires prompt medical attention, whereas chronic cholangitis may develop gradually due to persistent bile duct inflammation, commonly seen in conditions like primary sclerosing cholangitis (PSC). Risk factors include biliary tract obstructions, prior biliary surgery, or underlying liver diseases. Prevention involves managing underlying conditions and addressing potential sources of infection.