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Cholangitis

Cholangitis is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Partial or complete obstruction of the common bile duct owing to gallstones, tumor, cyst, or stricture
  • Increased intraluminal pressure in biliary tree
  • Bacterial multiplication results in bacteremia and sepsis.
  • Purulent infection of biliary tree, which may involve the liver and gallbladder
  • Mirizzi syndrome is defined as common bile duct obstruction owing to extrinsic compression from gallbladder or cystic duct edema or stones.

Etiology

  • Bacterial sources of infection include:
    • Ascending duodenal source
    • Gallbladder infection
    • Portal venous seeding
    • Hematogenous spread with hepatic secretion
    • Lymphatic spread
  • Bacterial organisms include:
    • Anaerobes (Bacteroides and Clostridium species)
    • Intestinal coliform (Escherichia coli)
    • Enterococcus
  • AIDS sclerosing cholangitis characterized by:
    • Papillary stenosis
    • Sclerosing cholangitis
    • Extrahepatic biliary obstruction
    • Cytomegalovirus (CMV), Cryptosporidium, and microsporidia isolated, but causal role not established

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Citation

Rosen, Peter, et al., editors. "Cholangitis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307129/1.3/Cholangitis.
Cholangitis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307129/1.3/Cholangitis. Accessed June 26, 2019.
Cholangitis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307129/1.3/Cholangitis
Cholangitis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307129/1.3/Cholangitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cholangitis ID - 307129 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307129/1.3/Cholangitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -