Cholangitis - Causes, Symptoms and Treatment .MF .
cholangitis - an inflammatory disease of the bile ducts.
Synthesis of bile in the liver, then it enters the bile canaliculi and thereon into intrahepatic bile ducts, which are the tree system that surrounds both lobes of the liver.
At the gates of the liver from the merger of the left and right branches, carrying bile from the right and left lobes of the liver hepatic duct is formed.Hepatic duct, cystic duct merging with, diverting bile from the gallbladder to form the common bile duct (choledoch).They constitute the extrahepatic biliary tract.Common bile duct opens on the mucous membrane of the duodenum, where and enters the bile.
There are acute, chronic, and primary sclerosing cholangitis.
extremely rare disease is primary, often cholangitis is a complication of cholecystitis, pancreatitis and gallstones.It may also occur on the background of tumors of the bile ducts, biliary tract abnormalities of development, after surgery on the abdominal organs.Occurrence of disease contr
Allocate primary sclerosing cholangitis, which is associated with inflammation is not an infection.The disease is caused by an autoimmune inflammatory disorders occur when the immune system and antibodies produced against its own healthy, normal body tissues, resulting in a gradual narrowing of extrahepatic and intrahepatic bile ducts.The causes of the disease are not fully known.Important role played by the family and genetic predisposition, stress.
symptoms of cholangitis.
Acute ascending cholangitis results from spreading the infection to the bile ducts from the gallbladder and pancreas.
Onset sudden, rapid.Increased body temperature to 40 degrees with stunning chills, there is intense cramping pain in the right half of the abdomen, chest, nausea, vomiting, severe weakness, blood pressure falls.
develops hepatic insufficiency: there is jaundice, itchy skin, impaired consciousness, which ultimately leads to the development of hepatic coma.Depending on the pathogen, the disease may be very severe.Therefore, when the first symptoms must be as soon as possible to see a doctor.
Chronic recurrent cholangitis.
case of brief, but often repeated violation of the outflow of bile develop chronic cholangitis.
In the period of acute pain in the right upper quadrant, fever, jaundice, itchy skin.Spontaneous bile outflow can be restored, then the pain subsides, decreases jaundice, improves the general condition of the patient.However, without early treatment, sooner or later there comes a relapse.
Primary sclerosing cholangitis.
Ill mostly young men.The disease develops gradually.It appears weakness, fatigue, aching pain in the right upper quadrant, the temperature rise to 38 degrees, jaundice, itchy skin.Often associated with other autoimmune diseases (ulcerative colitis, rheumatoid arthritis, thyroiditis, and others.)
survey of suspected cholangitis.
1. Ultrasonography (ultrasound).Identifies enlarged liver, bile duct expansion.
2. Endoscopic retrograde holangipankreatografiya.(ERCP).The main method of diagnosis.This X-ray examination of the bile ducts by direct injection of contrast medium into them through the endoscope.Identifies biliary tract changes.In primary sclerosing cholangitis detect changes busopodobnye large intrahepatic bile ducts on cholangiogram picture resembling dead tree.
It can be therapeutic manipulation in detecting stones and stenosis (narrowing) of the common bile duct.
3. Magnetic resonance cholangiography and CT data complement ERCP.
4. Duodenal intubation with bile study to determine the causative agent and its sensitivity to antibiotics.
1. Complete blood count.Identify signs of inflammation: increased erythrocyte sedimentation rate, white blood cells.
2. Biochemical analysis of blood: elevated levels of bilirubin, especially direct fraction, increased alkaline phosphatase, gamma-glutamyl transferase (GGT) - indicators of violations of the outflow of bile (cholestasis).The increased activity of transaminases (alanine -aminotransferazy - ALT, aspartate - aminotransferase - AST) - indicators of liver toxicity.
3. Urinalysis: appearance of bile pigments.
4. Fecal helminth eggs (opisthorchis, strongiloidy) and protozoa (Giardia).
cholangitis treatment is carried out in a specialized surgical hospital department.The main stage of surgical treatment is the elimination of the causes of the stagnation of bile, restore a full evacuation of bile.The question of the method of surgical treatment is made after a thorough examination, and depends on the specific clinical situation.laparoscopy is often performed.
Surgical treatment of cholangitis.Laparoscopy
in hospital for removal of intoxication syndrome - used detoxification therapy, bacterial cholangitis - antibiotics, with helminths - antiparasitic drugs.
In primary sclerosing cholangitis in the early stages of using drugs ursodeoxycholic acid.The dose, duration of admission will set only a doctor.But the only effective treatment is a liver transplant.
In the absence of timely treatment of inflammation of the bile duct to extend to the peritoneum - peritonitis occurs (inflammation of the peritoneum) of the surrounding tissue - formed subdiaphragmatic, intrahepatic abscesses, sepsis, bacterial - toxic shock.The condition of patients becomes extremely difficult and requires resuscitation.
Prolonged inflammation in chronic cholangitis leads to sclerotic changes in the tissues of the liver and the development of biliary cirrhosis.
self-medication and treatment of cholangitis folk remedies is unacceptable, because it can be lost time for treatment.In the later stages of the disease prognosis is poor.
prevention of cholangitis.
Early treatment of cholelithiasis, cholecystitis, pancreatitis and regular medical check-up at the family doctor, internist.
Medical consultation for cholangitis:
Question: When treating cholangitis is it possible to do without operation?
Answer: If cholangitis is caused due to blockage of bile ducts, it can not be cured until it is abolished obstruction outflow of bile.
Therapist Vostrenkova Irina