Acute cholangitis

Acute cholangitis is a potentially severe infection of the biliary tract, resulting from a biliary obstruction. The most frequent cause of cholangitis is common duct stones. Biliary tract obstruction and secondary bacterial colonization lead to infection. In most cases, the causative agents are intestinal microflora, mostly aerobic microorganisms (and, to a lesser extent, anaerobic bacteria). The Charcot triad constitutes the most frequent symptomatology. Diagnosis is confirmed by means of radiological techniques, such as ultrasonography, computed tomography scan, or magnetic resonance imaging of the liver, in which signs of obstruction of the biliary tract can be detected and its etiology can often be determined. In most patients the treatment of choice is early appropriate antimicrobial therapy and biliary drainage, generally using endoscopic techniques. (c) 2010 Elsevier Espana, S.L. All rights reserved.