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  • Pathophysiology of Cholangitis

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    Amni 'Pam' Zulkifar
    1K visualizações4 páginas
    Biliary obstruction causes increased pressure and ischemia in the bile ducts, predisposing them to bacterial infection that can ascend from the common bile duct. This progression can lead to acute suppurative cholangitis and systemic infection presenting as Charcot's triad or Reynold's pentad. Cholangitis is relatively uncommon but risks include age over 50, gallstones, strictures, and medical procedures or conditions compromising the biliary tract.

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    Biliary obstruction causes increased pressure and ischemia in the bile ducts, predisposing them to bacterial infection that can ascend from the common bile duct. This progression can lead to acute suppurative cholangitis and systemic infection presenting as Charcot's triad or Reynold's pentad. Cholangitis is relatively uncommon but risks include age over 50, gallstones, strictures, and medical procedures or conditions compromising the biliary tract.

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    Attribution Non-Commercial (BY-NC)
    Baixe no formato PPTX, PDF, TXT ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
    1K visualizações4 páginas

    Pathophysiology of Cholangitis

    Enviado por

    Amni 'Pam' Zulkifar
    Biliary obstruction causes increased pressure and ischemia in the bile ducts, predisposing them to bacterial infection that can ascend from the common bile duct. This progression can lead to acute suppurative cholangitis and systemic infection presenting as Charcot's triad or Reynold's pentad. Cholangitis is relatively uncommon but risks include age over 50, gallstones, strictures, and medical procedures or conditions compromising the biliary tract.

    Direitos autorais:

    Attribution Non-Commercial (BY-NC)
    Baixe no formato PPTX, PDF, TXT ou leia online no Scribd
    Sinalizar o conteúdo como inadequado
    de 4

    PATHOPHYSIOLOGY OF CHOLANGITIS

    Presence of biliary tract obstruction or stricture eg. choledocholithiasis Increase in intraluminal pressure causes dilatation Occlude vascular supply causing ischemia Predispose to bacterial infection from retrograde ascent

    Release of inflammatory mediators eg. PG

    Inflammatory exudate & bile stasis

    PROGRESSION TO ASCENDING CHOLANGITIS


    Infection in CBD extends proximally to intrahepatic duct system (biliary canaliculi, hepatic veins & peri-hepatic lymphatics)
    Go into acute suppurative cholangitis and systemic bacteremia as bacteria escape hepatic sinusoids Present as Charcots triad ( RUQ pain, fever and jaundice) or Reynolds pentad with altered mental status and signs of sepsis

    EPIDEMIOLOGY
    Relatively uncommon (1% develop secondary to cholelithiasis) 1-3% develop after ERCP due to poor biliary drainage Median age is from 50-60 years old Equal distribution for M & F

    RISK FACTORS
    Age > 50 years old Presence of cholelithiasis/ choledocholithiasis Benign stricture Malignant stricture Post-procedure injury Hx of Sclerosing Cholangitis HIV or parasitic infections

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