Ascending cholangitis causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2]
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Overview
Any condition that leads to stasis or obstruction of bile in the common bile duct can lead to bacterial infection and cholangitis. Most common causes include bile duct stones and benign or malignant strictures. Less common causes include parasitic infection, malignancy, or extrinsic compression by the pancreas. Partial obstruction has a higher rate of infection as compared to complete obstruction
Causes
Ascending Cholangitis results from a bacterial infection that is usually due to the bile stasis following a chronic obstruction. Some of the causes leading to ascending cholangitis are mentioned below.[1][2]
Common causes
The most common causes of ascending cholangitis include:[3]
- Choledocholithiasis / Common bile duct stones
- Benign Stenosis or strictures
- Post surgical
- Chronic pancreatitis
- Radiation induced
- Malignant Stenosis/Obstruction
- Cholangiocarcinoma
- Pancreatic cancer
- Gall bladder cancer
- Ampullary cancer
- Iatrogenic
- Following ERCP
- Post-operative biliary strictures
Less common causes
- Parasitic infections
- Ascaris lumbricoides
- Clonorchis sinensis
- Opisthorchis viverrini
- Ogatpisthorchis felineus
- Taenia saginata
- Malignancy[4]
- Sclerosing cholangitis
- Congenital causes
- Caroli Syndrome - rare disorder of intrahepatic bile duct
- Lemmel syndrome
- An obstructive jaundice syndrome due to a duodenal diverticulum which can displace or compress the bile duct or pancreatic duct opening leading to biliary obstruction and stasis
- Mirizzi Syndrome
- Common bile duct obstruction due to external compression by stones in cystic duct and gallbladder neck
Microbiology
The infecting organisms are usually gram-negative bacilli (eg, E. coli, Klebsiella, Pseudomonas, Bacteroides and Enterococcus).[5]
References
- ↑ Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M; et al. (2007). "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 15–26. doi:10.1007/s00534-006-1152-y. PMC 2784509. PMID 17252293.
- ↑ Mosler P (2011). "Management of acute cholangitis". Gastroenterol Hepatol (N Y). 7 (2): 121–3. PMC 3061017. PMID 21475420.
- ↑ Gigot JF, Leese T, Dereme T, Coutinho J, Castaing D, Bismuth H (1989). "Acute cholangitis. Multivariate analysis of risk factors". Ann Surg. 209 (4): 435–8. PMC 1493983. PMID 2930289.
- ↑ Serradilla Martin, M.; Palomares Cano, A.; Dabán Collado, E.; Medina Cuadros, M. (2016). "Acute cholangitis secondary to main bile duct thrombi for hepatocellular carcinoma". HPB. 18: e745–e746. doi:10.1016/j.hpb.2016.01.225. ISSN 1365-182X.
- ↑ Lipsett PA, Pitt HA (1990). "Acute cholangitis". Surg Clin North Am. 70 (6): 1297–312. PMID 2247816.