Cholangitis other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Blood tests to check levels of liver enzymes are the first step in diagnosing cholangitis. Doctors can confirm the diagnosis using cholangiography, which provides pictures of the bile ducts.
Other Diagnostic Studies
Blood Tests
A routine blood test can show:[1]
- Features of acute inflammation (raised white blood cell count and elevated C-reactive protein levels)
- Abnormal liver function tests (LFTs)
- LFTs will be consistent with the following obstructions:
- Raised bilirubin
- Increased alkaline phosphate levels
- Increased γ-glutamyl transpeptidase
- In early stages, pressure on the liver cells could be the main result on LFTs, so they might resemble those in hepatitis, with elevations in alanine transaminase and aspartate transaminase.
- LFTs will be consistent with the following obstructions:
Blood cultures are often performed in people with fever and evidence of acute infection. These yield the bacteria causing the infection in 36% of cases, usually after 24–48 hours of incubation. Bile, too, may be sent for culture during endoscopic retrograde cholangiopancreatography (ERCP). The most common types of bacteria linked to cholangitis are gram-positive and gram-negative.[2]
- Gram-negative includes:
- Escherichia coli (25–50%)
- Klebsiella (15–20%)
- Enterobacter (5–10%)
- Of the gram-positive strains, 10–20% of cases are caused by Enterococcus.