Gupta Arav, Simo Kerri
University of Cambridge
Recurrent pyogenic cholangitis (RPC) is a condition resulting from repeated infections of the biliary tree (cholangitis) first described in Hong Kong in 1930. It can also be referred to as Oriental cholangiohepatitis, Hong Kong disease, Oriental infestation cholangitis, or hepatolithiasis. Endemic to Southeast Asia, this disease is now seen worldwide due partly to increased population mobility and international travel. It is characterized by multiple intraductal calculi causing subsequent biliary tree dilatation and stricture. Patients typically present with repeating episodes of acute cholangitis and, beyond immediate management, are at greater risk of complications than more common types of cholangitis due to the chronicity of the disease. Given its significant overlap in clinical presentation with other cholangitis causes, diagnosis of RPC is challenging. It requires a multidisciplinary approach, including the emergency physician, gastroenterologist, surgeon, interventional radiologist, and histopathologist, amongst other specialists. This topic seeks to review the etiology, epidemiology, and pathophysiology, outline the evaluation and treatment of pyogenic cholangitis and its potential complications and risks, and highlight the healthcare team's role in managing patients with this condition.
复发性化脓性胆管炎（RPC）是一种由胆管反复感染（胆管炎）引起的疾病，1930年在香港首次被描述。它也可被称为东方胆管肝炎、香港病、东方感染性胆管炎或肝内胆管结石病。这种疾病在东南亚为地方病，如今由于人口流动性增加和国际旅行，在全球范围内都可见到。其特征是多个导管内结石导致随后的胆管扩张和狭窄。患者通常表现为反复出现的急性胆管炎发作，除了紧急处理外，由于疾病的慢性化，与更常见类型的胆管炎相比，患者出现并发症的风险更高。鉴于其临床表现与其他胆管炎病因有显著重叠，RPC的诊断具有挑战性。这需要多学科方法，包括急诊医生、胃肠病学家、外科医生、介入放射科医生和组织病理学家等其他专家。本主题旨在回顾病因、流行病学和病理生理学，概述化脓性胆管炎及其潜在并发症和风险的评估与治疗，并强调医疗团队在管理此类患者中的作用。
