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Digestive system
Digestive system


Bile pathway
Bile pathway


Definition:

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.



Causes, incidence, and risk factors:

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.

Risk factors include a previous history of gallstones , sclerosing cholangitis, HIV, narrowing of the common bile duct, and, rarely, travel to countries where you might catch a worm or parasite infection.



Symptoms:

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


Signs and tests:

Tests may include:

The following blood tests may be done:



Treatment:

Quick diagnosis and treatment are very important.

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

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



Support Groups:



Expectations (prognosis):

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



Complications:

Calling your health care provider:

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



Prevention:

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.



References:

Attasaranya S, Fogel EL.. Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis. Medical Clinics of North America. 2008 Jul;92(4).

Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 159.




Review Date: 9/20/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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