Cholangitis is inflammation in the biliary wall. It is usually due to the presence of gallstones. Acute Cholangitis requires rapid medical management.
What is Cholangitis?
Angiocholitis is an acute inflammation that occurs in the biliary tract wall.
What is the cause of acute cholangitis?
Cholangitis occurs in response to an infection of bile, a yellow-colored biological fluid involved in digestion. The germs responsible for this infection are bacteria including:
- Certain pathogenic strains of Escherichia coli;
- Pathogenic bacteria Streptococcus faecalis;
- Pathogenic bacteria Bacteroides fragilis.
Infection of bile usually occurs when there is an obstacle in the main bile duct. This obstruction is often related to a lithiasis of the main bile duct with the presence of gallstones, also called gallstones. Usually composed of crystallized cholesterol, the latter disrupt the flow of bile and promote the development of bacteria in the biliary tract wall. The presence of gallstones is involved in almost 90% of cases of cholangitis.
In a minority of cases, cholangitis may also be a consequence or complication that follows:
the presence of a tumor barrier, especially during cancer of the bile ducts or pancreatic cancer;
- A parasitic infection such as roundworm, flukes or hydatid vesicle;
- A surgical operation carried out in the bile ducts;
- Catheterization of the bile ducts , examination of the bile ducts;
- Endoscopic biliary sphincterotomy , section of a sphincter in the bile ducts by endoscopy.
Who is concerned ?
Angiocholitis mainly affects people with biliary lithiasis . There are several risk factors for gallstones, including age, obesity, diseases affecting the ileum , the resection of the ileum and taking certain medications.
What is the risk of complication?
Although the course of Cholangitis is variable, this inflammation can cause serious complications. Acute Cholangitis may include:
- The formation of an abscess in the liver ;
- The occurrence of sepsis ;
- An acute renal failure.
- Emergency medical care is necessary to limit the risk of complications.
What are the symptoms of Acute Cholangitis?
Angiocholitis is characterized by the occurrence of three symptoms, in a precise chronological order:
- Abdominal pain, which is similar to that of hepatic colic;
- A brutal and elevated fever, usually between 39 and 41 ° C, which appears shortly after the pain, is accompanied by chills and lasts from a few hours to a few days;
- A jaundice , or jaundice, which occurs one to two days after the first symptoms.
In the most severe forms, cholangitis may also be accompanied by confusional syndrome and disturbances of consciousness.
How to prevent cholangitis?
The prevention of inflammation involves preventing the development of gallstones, the main causes of cholangitis. For this, it is necessary to limit the factors increasing the risk of gallstones. It is particularly recommended to adopt a healthy lifestyle, with a balanced diet and regular physical activity.
How to treat cholangitis?
Acute cholangitis requires emergency medical care. The treatment of inflammation consists of eliminating infectious agents and treating the origin of the infection.
- To treat bile infection, antibiotic treatment is usually given intravenously.
- If the infection is due to the presence of gallstones, they can be removed by:
- A cholecystectomy , surgical treatment that involves removing the gallbladder ;
- cleaning of the bile ducts;
- Endoscopic biliary sphincterotomy, section of a sphincter in the bile ducts by endoscopy.