Ascending cholangitis causes: Difference between revisions
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{{Ascending cholangitis}} | {{Ascending cholangitis}} | ||
== Overview == | == 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 gallstones and benign or malignant strictures. Less common causes include parasitic infection, malignancy, or extrinsic compression by the pancreas. Partial obstruction is associated with a higher rate of infection than complete obstruction | |||
== Causes == | |||
Ascending Cholangitis results from bile stasis due to chronic obstruction which facilitates a bacterial infection. Some of the causes leading to ascending cholangitis are mentioned below<ref name="pmid17252293">{{cite journal| author=Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M et al.| title=Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. | journal=J Hepatobiliary Pancreat Surg | year= 2007 | volume= 14 | issue= 1 | pages= 15-26 | pmid=17252293 | doi=10.1007/s00534-006-1152-y | pmc=2784509 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17252293 }}</ref> | |||
=== Common causes === | |||
* [[Choledocholithiasis]] / Common bile duct stones | |||
* Benign Stenosis or strictures | |||
* Malignant Stenosis/Obstruction | |||
** [[Cholangiocarcinoma]] | |||
** [[Pancreatic cancer]] | |||
** [[Gall bladder cancer]] | |||
* Iatrogenic | |||
** Following [[Endoscopic retrograde cholangiopancreatography|ERCP]] | |||
** Post-operative biliary strictures | |||
=== Less common causes === | |||
* Parasitic infections | |||
** [[Ascaris lumbricoides]] | |||
** [[Clonorchis sinensis]] | |||
** [[Opisthorchis viverrini]] | |||
** Ogatpisthorchis felineus | |||
** [[Taenia saginata]] | |||
* [[Malignancy]] | |||
** [[Hepatoma]]<ref /> | |||
** [[Lymphoma]] | |||
** [[Metastasis]] to [[bile duct]] | |||
* [[Primary sclerosing cholangitis|Sclerosing cholangitis]] | |||
* Congenital causes | |||
** [[Caroli Syndrome]] - rare disorder of intrahepatic bile duct | |||
* Lemmel syndrome | |||
** It is a 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 bacteria|gram-negative bacilli]] (eg, [[E. coli]], [[Klebsiella]], [[Pseudomonas]], [[Bacteroides]] and [[Enterococcus]]) | |||
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== References == | == References == | ||
Revision as of 14:43, 24 September 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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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 gallstones and benign or malignant strictures. Less common causes include parasitic infection, malignancy, or extrinsic compression by the pancreas. Partial obstruction is associated with a higher rate of infection than complete obstruction
Causes
Ascending Cholangitis results from bile stasis due to chronic obstruction which facilitates a bacterial infection. Some of the causes leading to ascending cholangitis are mentioned below[1]
Common causes
- Choledocholithiasis / Common bile duct stones
- Benign Stenosis or strictures
- Malignant Stenosis/Obstruction
- Iatrogenic
- Following ERCP
- Post-operative biliary strictures
Less common causes
- Parasitic infections
- Ascaris lumbricoides
- Clonorchis sinensis
- Opisthorchis viverrini
- Ogatpisthorchis felineus
- Taenia saginata
- Malignancy
- Sclerosing cholangitis
- Congenital causes
- Caroli Syndrome - rare disorder of intrahepatic bile duct
- Lemmel syndrome
- It is a 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)
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.