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    Cholangitis

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

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    Emergency Central

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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/all/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/all/Cholangitis. Accessed April 22, 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/all/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 April 22]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307129/all/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/all/Cholangitis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -