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Cholangitis is a redness and swelling (inflammation) of the bile duct system.
The bile duct system carries bile from your liver and gallbladder into the first part of your small intestine (the duodenum).
In most cases cholangitis is caused by a bacterial infection. The infection often happens suddenly. But in some cases it may be long-term (chronic).
There are several health problems that may cause an infection in your bile duct system.
In most cases cholangitis is caused by a blocked duct somewhere in your bile duct system. The blockage may be from:
Cholangitis may also be caused when you have:
The infection causes pressure to build up in your bile duct system. It may spread to your liver if it’s not treated.
If you have had gallstones you are at greater risk for cholangitis. Other risk factors include:
Symptoms may be medium to severe. Each person’s symptoms may vary.
Symptoms may include:
The symptoms of cholangitis may look like other health problems. Always see your health care provider to be sure.
The pain from cholangitis can feel a lot like the pain from gallstones.
To be sure you have cholangitis, your health care provider will look at your past health and give you a physical exam. He or she may also use other tests.
You may have blood tests including:
You may also have imaging tests including:
It is important to get a diagnosis right away. Most people with cholangitis feel very sick. They see their health care provider or go to the emergency room.
If you have cholangitis, you will likely be in the hospital for a few days. You will be given fluids by IV (through a vein or intravenously). You will also have pain medicine and bacteria-fighting medicine (antibiotics).
You may also need to drain the fluid in your bile duct and find the cause of any blockage. In most cases this is done by a method called ERCP (endoscopic retrograde cholangiopancreatography).
To drain your bile duct using ERCP, a long thin flexible tube (endoscope) is put in your mouth. The scope goes down your food pipe (esophagus) and into your stomach. It passes into the first part of your small intestine (the duodenum) and into the bile ducts. The doctor can see the inside of these organs and ducts on a video screen. The video screen is connected to a camera in the scope. A small tube (called a T-tube) is passed into the ducts to drain fluid. This tube is brought out through the skin. This lets fluid drain out until the infection and inflammation clear up.
You may also have firm tubes (stents) put into the bile ducts to keep them open. Gallstones can also be removed. In most cases these things can be done using the ERCP scope.
You may need surgery if treatment doesn’t work or if you are getting worse. Surgery will open your ducts to drain the bile and fluid that’s building up.
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