Ascending cholangitis (patient information)

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 * Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [mailto:msbeih@perfuse.org]

Overview
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 liquid made by the liver that helps digest food.

What are the symptoms of Ascending cholangitis?
The following symptoms may occur:


 * Abdominal pain which is in the right upper side or middle of the upper abdomen and may come and go. Pain is sharp, crampy, or dull and may move to 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

What causes Ascending cholangitis?
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.

Who is at highest risk?
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.

Diagnosis
Tests may include:
 * Abdominal ultrasound
 * Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that enables your surgeon to examine the pancreatic and bile ducts.
 * Magnetic resonance cholangiopancreatography (MRCP)which is a noninvasive test that can image the biliary tree.
 * Percutaneous transhepatic cholangiogram (PTCA which is an x-ray of the bile ducts, the tubes that carry bile from the liver to the gallbladder and small intestine.

The following blood tests may be done:
 * Bilirubin level
 * Liver enzyme levels
 * Liver function tests
 * White blood count (WBC)

When to seek urgent medical care?
Call for an appointment with your health care provider if you have symptoms of cholangitis.

Treatment options
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.

Where to find medical care for Ascending cholangitis?
Directions to hospitals treating ascending cholangitis

What to expect (Outlook/Prognosis)?
The outcome is usually good with treatment, but poor without it.