What is Cholangitis?
The pancreatic juices from the pancreas and the bile from the gall bladder reach the duodenum through the common bile duct. Bile is produced by the liver and is stored in the gall bladder. Bile and juices from the pancreas help in the metabolism of food.
Gall stones or tumours may cause obstruction in the common biliary tract carrying the bile and pancreatic juices leading to an infection. The bacterial infection occuring in an obstructed biliary tract is referred to as
Women are at a greater risk of this condition than men. The condition is mostly seen after the age of 55. A previous history of gall stones puts one at a greater risk of getting the disease.
What are the Causes of Cholangitis?
- Gall stones.
- Bile duct narrowing.
- Swelling, scarring and destruction of bile ducts as in primary sclerosing cholangitis.
- Bile duct tumor.
- Ampullary tumor.
- Pancreatic Head Tumor.
- Acute pancreatitis.
- Blood Clots.
- Bacterial backflow from the small intestine.
- Parasites or worms causing the obstruction.
Symptoms of the Condition
The symptoms of the condition could be intense. The following are some of the most common symptoms:
- Abdominal pain in the upper right quadrant.
- Pain may be intermittent and may tend to radiate towards the back and shoulders.
- Fever with chills.
- Jaundice or yellowing of the skin and eyes.
- Pale or clay colored stools.
- Dark urine.
- Low blood pressure.
- Change in mental status as in coma, anxiety or delirium.
Diagnostic Tests to detect the condition
- Bilirubin Level
- Liver Enzyme Tests
- Liver Function Tests
- Leukocyte or White Blood Count (WBC)
- Complete Blood Count (CBC)
- Amylase levels ( Elevated in case of pancreatitis).
Diagnostic and Investigative procedures conducted to detect the condition
- Ultrasound of the abdomen.
- Endoscopic Retrograde Cholangiopnacreatography (ERCP)
- Magnetic Resonance Cholangiopancreatography (MRCP)
- Percutaneous Transhepatic Cholanglogram (PTCA)
Treatment of Cholangitis
Treatment of the condition involves managing the infection with antibiotics. The obstruction in the bile duct needs to be addressed at the same time. The treatment procedures include the following:
- Administering antibiotics intravenously.
- Decompressing the bile duct and removing the blockage with the help of an endoscope ( a nasogastric tube inserted through the mouth and reaching on to the bile duct).
- Blood pressure medications if it is dropping beyond the normal reference range for the individual.