- Acute cholangitis is a bacterial infection of the biliary tract that results from biliary obstruction. The organisms typically ascend from the duodenum.
- The most common cause is choledocholithiasis, although neoplasms, postoperative strictures, or other causes of obstruction may be involved.
- Acute cholangitis is characterized by Charcot’s triad of jaundice, right upper quadrant abdominal pain, and fever.
- Acute suppurative cholangitis occurs with the presence of pus in the biliary ducts and may result in Reynold’s pentad: Charcot’s triad plus hypotension and confusion.
- If present, the disease can become rapidly fatal. Initial treatment includes antibiotics,
fluid and electrolyte replacement, and analgesia. - ECRP is the optimal procedure for both diagnosis and treatment when the patient is
stable. - Percutaneous transhepatic cholangiography or open surgical decompression may be required.