Virgile Jennifer, Marathi Rachana
University of Mississippi Medical Center
Acute cholangitis, also known as ascending cholangitis, is a life-threatening condition caused by an ascending bacterial infection of the biliary tree. Choledocholithiasis is the most common cause, with infection-causing stones in the common bile duct leading to partial or complete obstruction of the biliary system. The diagnosis is made by clinical presentation, abnormal laboratory results, and imaging studies implying infection and biliary obstruction. Initial medical therapy relies on early fluid resuscitation and appropriate antibiotic coverage. Delay in treatment can lead to septic shock. Depending on the course and severity, a biliary drainage procedure may be performed with the assistance of endoscopic and surgical resources. Acute cholangitis is a treatable condition when managed appropriately. However, mortality can be quite high if there is a significant delay in treatment. There are various types of cholangitis, including primary biliary cholangitis, IgG4-related autoimmune cholangitis, and primary sclerosing cholangitis. By far, the most common is acute bacterial cholangitis and will be the focus of this review article.
急性胆管炎，又称上行性胆管炎，是一种由胆道系统细菌逆行感染引起的危及生命的疾病。胆总管结石是最常见的病因，胆总管内引起感染的结石导致胆道系统部分或完全梗阻。诊断依据临床表现、异常实验室检查结果以及提示感染和胆道梗阻的影像学检查。初始药物治疗依赖于早期液体复苏和适当的抗生素覆盖。治疗延迟可导致感染性休克。根据病程和严重程度，可在内镜和外科手段的辅助下进行胆道引流手术。急性胆管炎若得到恰当处理是可治疗的疾病。然而，如果治疗严重延迟，死亡率可能会相当高。胆管炎有多种类型，包括原发性胆汁性胆管炎、IgG4相关自身免疫性胆管炎和原发性硬化性胆管炎。到目前为止，最常见的是急性细菌性胆管炎，这将是本文综述的重点。
