Cholangitis is the inflammation of the bile duct caused by their infection. The disease develops, usually due to the ingress of bacteria or parasites into the bile ducts through the lumen of the duodenum, lymph or blood. Often, cholangitis, the symptoms of which are similar to other liver diseases, is accompanied by the formation of cysts, ductal cancer or choledocholithiasis (stones in the common duct).
Causes and types of cholangitis
The disease almost always develops against the background of stagnation of bile, which is typical for cholecystitis and cholelithiasis, ascariasis and tumors in the liver. The probability of infection of the bile ducts through the gastrointestinal tract increases in this case.
According to the nature of the current, doctors distinguish:
- acute cholangitis;
- chronic cholangitis.
In turn, the acute form is classified into:
- catarrhal;
- necrotic;
- diphtheria;
- purulent cholangitis.
The same chronic form can be expressed:
- latent;
- abscessing;
- recurrent;
- long-running septic;
- primary sclerosing cholangitis.
Symptoms of cholangitis
The acute form of the disease makes itself felt by a pain attack, the character of which resembles a hepatic colic. The next symptom of cholangitis is the so-called mechanical jaundice, in which the skin, sclera, and mucous become yellow. The patient raises the temperature, the skin begins to itch, the tongue is laid.
At palpation the doctor reveals that the liver is enlarged in size, and its edge is rounded.
Analyzes show:
- leukocytosis with a left shift;
- increased direct bilirubin;
- increase in alkaline phosphatase.
The content of ALT and ACT (hepatic enzymes) increases slightly.
To diagnose acute cholangitis allows ultrasound of the liver and ducts.
If the treatment is not started on time, the inflammation can affect the surrounding tissues, which threatens with sepsis, peritonitis (the lethality is extremely high), as well as the development of abscesses and sclerosing changes in the liver.
Symptoms of chronic cholangitis
The chronic form can develop on its own, but more often it is a reminder of the previously transferred acute inflammation of the bile ducts. The chronic cholecystitis mentioned above, cholelithiasis and other pathologies associated with congestion of bile also provoke chronic cholangitis.
Patients complain of dull pain in the liver (right hypochondrium), severe fatigue. The skin itches, there is a slight icterus and subfebrile condition (temperature 37 - 37.5 ° C for several weeks).
Some patients have attacks of acute pain in the right hypochondrium and epigastrium, which gives under the scapula, behind the sternum and the heart area.
Noticeable jaundice appears already at later stages. Complications of the disease is cholangiogenic hepatitis with the subsequent development of liver cirrhosis, pancreatitis.
Primary sclerosing cholangitis
One form of chronic cholangitis is primary sclerosing, the symptoms of which are generally similar to those described above. This inflammation is accompanied by the formation of scars in the biliary tract. Doctors have not yet established an accurate
Progression of such a cholangitis is rather slow, and its signs then appear, then disappear. The patient periodically complains of abdominal pain and severe fatigue. Sclera and skin turn yellow, there is an itch and a fever. Often, primary sclerosing cholangitis develops in people with chronic inflammatory bowel diseases - the main symptom of this is an increase in alkaline phosphatase three times the normal level, in the absence of any other symptoms.