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Cholangitis: Definition, Symptoms & Treatment

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson defines a painful condition known as cholangitis. You'll learn its most important signs and symptoms, possible causes as well as general forms of treatment.

What is Cholangitis?

John loves bacon, but he also loves his veggies. From the bacon, he gets plenty of dietary fat. From the veggies, he gets plenty of fat soluble vitamins. And he can thank a digestive liquid, called bile, for the digestion and absorption of both. Bile is made in the liver, transported via a bile duct system to the gallbladder, and secreted from there into the intestines via this duct system when you eat.

But John doesn't feel so well. That's because he has cholangitis, which narrowly refers to the inflammation ('-itis') of a bile duct ('cholang-'). More broadly, this refers to the inflammation and/or infection of the bile duct system. The infection, usually bacterial in nature, is the result of rapid bacterial proliferation stemming from an obstruction of the biliary duct system.

The biliary duct system.
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Let's learn more about this condition's signs, symptoms, and treatment options.

Signs & Symptoms

John is complaining of quite a few things which, when put together, are potentially indicative of cholangitis. They include:

  • A fever, often with chills. The fever is often sudden in its onset.
  • Pain, specifically in the right upper quarter (quadrant) of his abdomen.
  • Jaundice, the yellowing of his skin, whites of the eyes and mucous membranes. The mucous membranes are pink and moist membranes, such as those that line the inside of the mouth.

Those are the three most frequent and important signs of cholangitis you must be able to recall. Together, they are known as Charcot's triad. While they may all be present in a person with cholangitis, as in John's case, they don't have to be. If they are present together with:

  • Hypotension, low blood pressure
  • Changes in a person's mental status

Then this is known as Reynold's Pentad. This is indicative of a severe form of cholangitis that includes a life-threatening complication known as septic shock. This is where a person's tissues and organs do not receive enough blood flow and begin to fail as a result. Thankfully, John doesn't have these signs, but he needs treatment quick or else it can definitely progress to that!

Causes & Treatment

Traditionally, cholangitis was seen as a condition caused by the obstruction of the common bile duct with a stone from the gallbladder, a condition known as choledocholithiasis. 'Choledocho-' refers to the common bile duct, '-lith-' refers to stone and '-iasis' refers to an abnormal condition of some sort.

However, other possible causes of cholangitis include the likes of:

  • Obstruction of the bile duct as a result of a tumor affecting the pancreas, gallbladder or liver
  • Infections with parasites, such as Ascaris lumbricoides
  • Stenosis, or narrowing, of the biliary duct system as a result of prior surgery in the area

Depending on the exact cause of the cholangitis, treatment options will vary but they generally include:

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