Cholangitis is an infection of the bile duct, the tube that carries bile from the liver to the gallbladder and intestines. Bile is a liquid made by the liver that helps digest food.
Cholangitis is most often caused by a bacterial infection. This can occur when the duct is blocked by something, such as a gallstone or tumor. The infection causing this condition may also spread to the liver.
Risk factors include a previous history of gallstones, sclerosing cholangitis, HIV, narrowing of the common bile duct, and, rarely, travel to countries where you might catch a worm or parasite infection.
The following symptoms may occur:
- Pain on the upper right side or upper middle part of the abdomen. It may also be felt in the back or below the right shoulder blade. The pain may come and go and feel sharp, cramp-like, or dull.
- Fever and chills
- Dark urine and clay-colored stools
- Nausea and vomiting
- Yellowing of the skin (jaundice), which may come and go
Exams and Tests
You may have the following tests to look for blockages:
- Abdominal ultrasound
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Magnetic resonance cholangiopancreatography (MRCP)
- Percutaneous transhepatic cholangiogram (PTCA)
You may also have the following blood tests:
Quick diagnosis and treatment are very important.
Antibiotics to cure infection is the first treatment done in most cases. ERCP or other surgical procedure is done when the patient is stable.
Patients who are very ill or are quickly getting worse may need surgery right away.
The outcome is very often good with treatment, but poor without it.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of cholangitis.
Treatment of gallstones, tumors, and infestations of parasites may reduce the risk for some people. A metal or plastic stent that is placed in the bile system may be needed to prevent the infection from returning.
Afdhal NH. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 158.
Update Date 5/15/2014
Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.