ACUTE (ASCENDING) CHOLANGITIS - 04/09/11
Résumé |
Cholangitis includes acute (ascending) cholangitis, oriental or recurrent cholangitis, acquired immunodeficiency syndrome (AIDS)-related sclerosing cholangitis (AIDS cholangiopathy), and primary sclerosing cholangitis (PSC). This review covers the first two. AIDS cholangiopathy recently has been reviewed,171 and PSC is an immunologic entity that has been described elsewhere.4, 139
Acute cholangitis occurs in an infected, usually obstructed biliary system, most often at the level of the common bile duct. The most common cause of obstruction is stones, but other causes include strictures, which form after surgery or endoscopy or which may be secondary to sclerosing cholangitis; cysts; diverticula; congenital abnormalities; choledochoceles; pancreatitis; pancreatic or choledochal neoplasms; parasites (Ascaris, Clonorchis, or Echinococcus spp.); blockage in a drainage tube; or extrinsic compression.* The obstruction is usually complete, and, as a result, the infected material is unable to drain adequately. Concomitant increased intraductal pressure can lead to reflux of biliary contents and bacteremia, which in turn can cause septic shock and death.†
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| Address reprint requests to Lawrence H. Hanau, MD, PhD, AIDS Center, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467 |
Vol 14 - N° 3
P. 521-546 - septembre 2000 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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