Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Feb 15, 2018; 9(1): 1-7
Published online Feb 15, 2018. doi: 10.4291/wjgp.v9.i1.1
Acute cholangitis - an update
Monjur Ahmed
Monjur Ahmed, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: Ahmed M solely contributed to this work.
Conflict-of-interest statement: None to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Monjur Ahmed, MD, FRCP, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Thomas Jefferson University, 132 South 10th Street, Suite 468, Main Building, Philadelphia, PA 19107, United States.
Telephone: +1-215-9521493 Fax: +1-215-7551850
Received: April 6, 2017
Peer-review started: April 10, 2017
First decision: May 26, 2017
Revised: July 5, 2017
Accepted: October 30, 2017
Article in press: October 30, 2017
Published online: February 15, 2018

Acute cholangitis is bacterial infection of the extra-hepatic biliary system. As it is caused by gallstones blocking the common bile duct in most of the cases, its prevalence is greater in ethnicities with high prevalence of gallstones. Biliary obstruction of any cause is the main predisposing factor. Diagnosis is established by the presence of clinical features, laboratory results and imaging studies. The treatment modalities include administration of intravenous fluid, antibiotics, and drainage of the bile duct. The outcome is good if the treatment is started early, otherwise it could be grave.

Keywords: Acute cholangitis, Ascending cholangitis, Biliary infection, Hepatic fever, Infection of the bile duct

Core tip: Acute cholangitis is a serious medical problem unless treated early. High clinical suspicion is essential to diagnose this condition. The different diagnostic criteria, treatment options, including different modalities of biliary drainage, and prognosis are described in this article.