29 May

Cholangitis - Causes, Symptoms , Treatments

Contents:

1. Causes of cholangitis

2. main forms of disease

3. symptoms of cholangitis

4. Diagnosis and treatment of diseases

cholangitis- nonspecific inflammatory disease of the bile ducts, which has an acute or chronic course.In most cases, the disease is combined with other diseases, often with inflammation of the liver or gall bladder.

Causes of cholangitis

Depending on the reason for the appearance and characteristics of the disease distinguish between acute, chronic, sclerosing cholangitis.

Pathogens of acute cholangitis - many pathogenic bacteria and single-celled microorganisms.In biliary tract they usually get from the gall bladder and intestinal lumen.Sometimes the pathogen can penetrate into the bile ducts of the other organs through the bloodstream or lymph.The most common causative agents of acute cholangitis forms are Escherichia coli, Klebsiella (the pathogen of the Enterobacteriaceae family), enterococci, giardia, Bacteroides, opisthorchis (kind of worms).

In most cases, acute cholangitis develops in people who have a violation of the outflow of bile during such diseases as cholecystitis, cholelithiasis, gastroduodenitis, pancreatitis, ascariasis, neoplastic process in the liver.This is due to the fact that bile stasis increases the risk of penetration of pathogens into the bile ducts.

cause of chronic cholangitis can be transferred an acute form of the disease or the development of chronic disease course in people with recurrent attacks of some diseases.Such diseases include cholecystitis, gastroduodenitis, pancreatitis and others.Chronic cholangitis is most common in older people.

special kind of cholangitis, primary sclerosing, is an autoimmune disease.It was found that this type of the disease is usually associated in patients with ulcerative colitis, Crohn's disease, thyroiditis, Riedel's and other diseases.

main forms of disease

Depending on the type of inflammation of acute cholangitis is the following forms:

  • catarrhal - edema of the mucous tissue of the bile ducts;if left untreated, this form becomes a chronic scar constrictions ducts;
  • purulent - the bile ducts are filled with bile, mixed with purulent discharge;this form of the disease often involves purulent process liver and gall bladder;
  • diphtheritic - on the mucous membranes of the biliary tract ulcers are formed, followed by necrosis (tissue necrosis);as a result of broken walls, and the ducts occurs purulent fusion of the liver and surrounding tissue;
  • necrotic - in the bile ducts get aggressive pancreatic enzymes;consequently on the mucosa of the biliary tract develop areas of necrosis.

By the nature of the flow are the following forms of chronic cholangitis - latent, recurrent, septic and primary sclerosing cholangitis.

symptoms of cholangitis

Most often the symptoms of acute cholangitis forms appear suddenly.The patient's body temperature rises sharply to 39-40? C, there is a distinct chill.Along with these features in the right upper quadrant pain arises of varying intensity, resembling biliary colic.The pain may be given in the right shoulder blade, spread to the neck and right shoulder.As a result of intoxication the patient has nausea, vomiting, headache, general weakness.

With further development of the disease appear the following symptoms of cholangitis - yellowing of the sclera of eyes and skin (jaundice).At the same time, patients suffer from skin itching, especially at night.

Acute cholangitis in children is rare.Generally, it appears as a secondary infection, most commonly streptococcus, in other diseases.This form of the disease occurs in children very rapidly, its symptoms are identical to the grounds of any acute disease of the gastrointestinal tract.This results in that the acute cholangitis children often mistaken for another disease.

Signs of chronic cholangitis appear gradually.

Symptoms of chronic cholangitis form depends on the type of the disease.

latent form of the disease is characterized by minor pain or its absence.The patient may be a weakness, itching, and sometimes low-grade fever.

When recurrent form of chronic cholangitis appears intermittent pain that is accompanied by sweating, chills, fever.

Septic form - the most rare.Its pathogen is Streptococcus zelenyaschy.The disease is hard enough.The patient is shown enlarged spleen, bacteraemia (bacteria getting into the blood), kidney damage.

In the case of primary sclerosing cholangitis affects extrahepatic or intrahepatic ducts.The main symptoms of this type of cholangitis are jaundice and skin itching.In the later stages of the disease the patient develops cirrhosis.

In chronic course of cholangitis in children there is no appetite, nausea, pallor, or jaundice of the skin.In children, reduced body weight, anemia, persistent headaches.Perhaps the child behind in the overall development.

Diagnosis and treatment of diseases Treatment

cholangitis appointed after a thorough diagnosis of the patient, determining the type and stage of disease.

cholangitis Diagnosis involves examination of the patient, hardware and laboratory studies.

The hardware diagnostic methods for this disease are:

  • ultrasound of the liver, gallbladder, bile ducts;
  • fluoroscopy biliary tract using intravenous contrast material, which gives the opportunity to explore extrahepatic and intrahepatic ducts;
  • radioisotope examination of the biliary tract;
  • fluoroscopy biliary and pancreatic ducts using a contrast agent, injected endoscopically;
  • definition of pressure inside the bile ducts;
  • endoscopic examination of the biliary tract;
  • laboratory analyzes of bile;
  • general and biochemical blood test.

cholangitis treatment is usually performed in a hospital.This is due to the fact that this disease may have many serious complications (purulent abscesses of the liver and gallbladder, liver cirrhosis, peritonitis).Depending on severity of the disease, presence or absence of clogging of the biliary tract, the treatment is carried cholangitis conservative or surgical methods.

In early conservative treatment the patient must be fasting for a few days with the transition to a sparing diet.At the same time it is prescribed antibiotics broad spectrum of action.When pain syndrome is used analgesics and antispasmodics.In the case of symptoms of intoxication patient makes intravenous infusion of saline and glucose.

cholangitis Surgical treatment is necessary if you can not make a normal outflow of bile by means of conservative therapy.Surgery is most often carried out by endoscopy.

Attention!

This article is available exclusively in the educational purposes and is not research material or professional medical advice.

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