Mohammad Alizadeh AH. Cholangitis: diagnosis, treatment and prognosis. J Clin Transl Hepatol. 2017 Dec 28. 5 (4):404-13. [QxMD MEDLINE Link]. [Full Text].
Aron JH, Bowlus CL. The immunobiology of primary sclerosing cholangitis. Semin Immunopathol. 2009 Sep. 31(3):383-97. [QxMD MEDLINE Link]. [Full Text].
Kashyap R, Mantry P, Sharma R, et al. Comparative analysis of outcomes in living and deceased donor liver transplants for primary sclerosing cholangitis. J Gastrointest Surg. 2009 Aug. 13(8):1480-6. [QxMD MEDLINE Link].
Jabara B, Fargen KM, Beech S, Slakey DR. Diagnosis of cholangiocarcinoma: a case series and literature review. J La State Med Soc. 2009 Mar-Apr. 161(2):89-94. [QxMD MEDLINE Link].
van Erpecum KJ. Gallstone disease. Complications of bile-duct stones: Acute cholangitis and pancreatitis. Best Pract Res Clin Gastroenterol. 2006. 20(6):1139-52. [QxMD MEDLINE Link].
Rosing DK, De Virgilio C, Nguyen AT, El Masry M, Kaji AH, Stabile BE. Cholangitis: analysis of admission prognostic indicators and outcomes. Am Surg. 2007 Oct. 73(10):949-54. [QxMD MEDLINE Link].
Tan M, Schaffalitzky de Muckadell OB, Laursen SB. Association between early ERCP and mortality in patients with acute cholangitis. Gastrointest Endosc. 2018 Jan. 87 (1):185-92. [QxMD MEDLINE Link].
Schneider J, Hapfelmeier A, Thores S, et al. Mortality risk for acute cholangitis (MAC): a risk prediction model for in-hospital mortality in patients with acute cholangitis. BMC Gastroenterol. 2016 Feb 9. 16:15. [QxMD MEDLINE Link].
Schwed AC, Boggs MM, Pham XD, et al. Association of admission laboratory values and the timing of endoscopic retrograde cholangiopancreatography with clinical outcomes in acute cholangitis. JAMA Surg. 2016 Nov 1. 151 (11):1039-45. [QxMD MEDLINE Link].
Tabibian JH, Yang JD, Baron TH, Kane SV, Enders FB, Gostout CJ. Weekend admission for acute cholangitis does not adversely impact clinical or endoscopic outcomes. Dig Dis Sci. 2016 Jan. 61 (1):53-61. [QxMD MEDLINE Link].
Kinney TP. Management of ascending cholangitis. Gastrointest Endosc Clin N Am. 2007 Apr. 17(2):289-306, vi. [QxMD MEDLINE Link].
Shinya S, Sasaki T, Yamashita Y, et al. Procalcitonin as a useful biomarker for determining the need to perform emergency biliary drainage in cases of acute cholangitis. J Hepatobiliary Pancreat Sci. 2014 Oct. 21 (10):777-85. [QxMD MEDLINE Link].
Attasaranya S, Fogel EL, Lehman GA. Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis. Med Clin North Am. 2008 Jul. 92(4):925-60, x. [QxMD MEDLINE Link].
Cremer A, Arvanitakis M. Diagnosis and management of bile stone disease and its complications. Minerva Gastroenterol Dietol. 2016 Mar. 62 (1):103-29. [QxMD MEDLINE Link].
Rustemovic N, Cukovic-Cavka S, Opacic M, et al. Endoscopic ultrasound elastography as a method for screening the patients with suspected primary sclerosing cholangitis. Eur J Gastroenterol Hepatol. 2010 Jun. 22(6):748-53. [QxMD MEDLINE Link].
Iorgulescu A, Sandu I, Turcu F, Iordache N. Post-ERCP acute pancreatitis and its risk factors. J Med Life. 2013 Mar 15. 6(1):109-13. [QxMD MEDLINE Link]. [Full Text].
Wilkins T, Agabin E, Varghese J, Talukder A. Gallbladder dysfunction: cholecystitis, choledocholithiasis, cholangitis, and biliary dyskinesia. Prim Care. 2017 Dec. 44 (4):575-97. [QxMD MEDLINE Link].
Zhang RL, Zhao H, Dai YM, et al. Endoscopic nasobiliary drainage with sphincterotomy in acute obstructive cholangitis: a prospective randomized controlled trial. J Dig Dis. 2014 Feb. 15 (2):78-84. [QxMD MEDLINE Link].
Sharma BC, Agarwal N, Sharma P, Sarin SK. Endoscopic biliary drainage by 7 Fr or 10 Fr stent placement in patients with acute cholangitis. Dig Dis Sci. 2009 Jun. 54(6):1355-9. [QxMD MEDLINE Link].
Itoi T, Kawai T, Sofuni A, et al. Efficacy and safety of 1-step transnasal endoscopic nasobiliary drainage for the treatment of acute cholangitis in patients with previous endoscopic sphincterotomy (with videos). Gastrointest Endosc. 2008 Jul. 68(1):84-90. [QxMD MEDLINE Link].
Lin H, Li S, Liu X. The safety and efficacy of nasobiliary drainage versus biliary stenting in malignant biliary obstruction: A systematic review and meta-analysis. Medicine (Baltimore). 2016 Nov. 95 (46):e5253. [QxMD MEDLINE Link].
Park TY, Choi JS, Song TJ, et al. Early oral antibiotic switch compared with conventional intravenous antibiotic therapy for acute cholangitis with bacteremia. Dig Dis Sci. 2014 Nov. 59(11):2790-6. [QxMD MEDLINE Link].
Tabibian JH, Yang JD, Baron TH, Kane SV, Enders FB, Gostout CJ. Weekend admission for acute cholangitis does not adversely impact clinical or endoscopic outcomes. Dig Dis Sci. 2015 Sep 21. [QxMD MEDLINE Link].
Zimmer V, Lammert F. Acute bacterial cholangitis. Viszeralmedizin. 2015 Jun. 31 (3):166-72. [QxMD MEDLINE Link].

Media Gallery

Sonogram of dilated intrahepatic ducts.
CT scan of common bile duct occluded by stone. Image courtesy of David Schwartz, MD, New York University Hospital.
CT scan of 1-cm dilated common bile duct at portal triad. Image courtesy of David Schwartz, MD, New York University Hospital.
CT scan of dilated intrahepatic bile ducts. Image courtesy of David Schwartz, MD, New York University Hospital.
Algorithm for management of patients with acute cholangitis.

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Author

Timothy M Scott, DO Chief Resident, Department of Emergency Medicine, Detroit Medical Center, Wayne State University School of Medicine

Timothy M Scott, DO is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Osteopathic Association, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Coauthor(s)

Adam J Rosh, MD Assistant Professor, Program Director, Emergency Medicine Residency, Department of Emergency Medicine, Detroit Receiving Hospital, Wayne State University School of Medicine

Adam J Rosh, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Program Director, Emergency Medicine, Einstein Medical Center Montgomery

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Eugene Hardin, MD, FAAEM, FACEP Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center

Disclosure: Nothing to disclose.

Jeffrey A Manko, MD A ssistant Professor of Emergency Medicine, Director, Emergency Medicine Residency Program, Consulting Staff, Emergency Medicine Services, New York University/Bellevue Medical Center

Jeffrey A Manko, MD is a member of the following medical societies: American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Sally Santen, MD Program Director, Assistant Professor, Department of Emergency Medicine, Vanderbilt University

Sally Santen, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

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