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Acute cholangitis, also known as ascending cholangitis, is a life-threatening condition caused by an ascending bacterial infection of the biliary tree.Choledocholithiasis is the most common cause, with infection-causing stones in the common bile duct leading to partial or complete obstruction of the biliary system. The diagnosis is made by clinical presentation, abnormal laboratory results, and imaging studies implying infection and biliary obstruction.

Initial medical therapy relies on early fluid resuscitation and appropriate antibiotic coverage. Delay in treatment can lead to septic shock. Depending on the course and severity, a biliary drainage procedure may be performed with the assistance of endoscopic and surgical resources. Acute cholangitis is a treatable condition when managed appropriately. However, mortality can be quite high if there is a significant delay in treatment. There are various types of cholangitis, including primary biliary cholangitis, IgG4-related autoimmune cholangitis, and primary sclerosing cholangitis. By far, the most common is acute bacterial cholangitis and will be the focus of this review article.


Pain in the upper right part of your belly (abdomen)



Yellowing of the skin and eyes (jaundice)

Nausea and vomiting.

Clay-colored stools.

Dark urine.

Low blood pressure.


What causes cholangitis? In most cases cholangitis is caused by a blocked duct somewhere in your bile duct system. The blockage is most commonly caused by gallstones or sludge impacting the bile ducts. Autoimmune disease such as primary sclerosing cholangitis may affect the system.

Risk factors

Liver disease and failure. ...

Repeated infections. ...

Portal hypertension. ...

Thinning bones. ...

Bile duct cancer. ...

Colon cancer.

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Acute cholangitis can range in severity from mild disease to liver or multiorgan failure. Following complications are associated with cholangitis:

Hepatic abscess

Acute cholecystitis

Portal vein thrombosis

Acute biliary pancreatitis

Liver failure

Acute renal failure


Multiple organ failure


Because doctors do not know the cause of PBC, it cannot be prevented. However, you can take steps to lessen liver damage, including:

Quit smoking, stop drinking alcohol and stop using illegal drugs

Take all medicines as directed by your doctor.

Eat a healthy, well balanced diet.

Get regular exercise, such as walking.

Healthy food choices could include eating foods rich in vitamins A, D, E and K and/or supplements of these vitamins. Also, foods high in vitamin D and calcium could help prevent osteoporosis. Ask your doctor for specific foods high in these vitamins and minerals.

Foods to avoid include raw shellfish (because of possible bacteria presence); plus food high in salt, fat, and carbohydrates – especially added sugars.