- Author: Homayoun Shojamanesh, MD; Chief Editor: Julian Katz, MD more...
Cholangitis is an infection of the biliary tract with the potential to cause significant morbidity and mortality. Many patients with acute cholangitis respond to antibiotic therapy; however, patients with severe or toxic cholangitis may not respond and may require emergency biliary drainage. Jean M. Charcot recognized this illness in 1877 when he described a triad of fever, jaundice, and right upper quadrant pain. In 1959, Reynolds and Dargon described a more severe form of the illness that included the additional components of septic shock and mental confusion, which is referred to as the Reynolds pentad.
Historically, choledocholithiasis was the most common cause of biliary tract obstruction resulting in cholangitis. Over the past 20 years, biliary tract manipulations/interventions and stents have reportedly become more common causes of cholangitis. Hepatobiliary malignancies are a less common cause of biliary tract obstruction and subsequent bile contamination.
The condition has significant potential for mortality and morbidity, especially if left untreated. Reported mortality rates vary from 13 to 88%.
Cholangitis is reported in all races. One variant, Asian cholangitis (also referred to as recurrent pyogenic cholangitis), is observed with increased frequency in Southeast Asia.
The condition is reported in both females and males and has no clear predominance in either.
The condition mostly occurs in adults, with a reported median age at onset of 50-60 years.
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