0071643192.pdf

Cholangitis

Cholangitis is an acute bacterial infection of the biliary tree that commonly

occurs secondary to obstruction, usually from gallstones (choledocholithiasis) or

primary sclerosis cholangitis (progressive inflammation of the biliary tree associ-

ated with ulcerative colitis). Gram-negative enterics (eg, E. coli, Enterobacter,

ABDOMINAL AND GASTROINTESTINAL

EMERGENCIES

7

A

14

10

B

FIGURE 11.10. (A) Normal HIDA scan.IV dye is taken up by hepatocytes, conjugated,

and excreted into the common bile duct. (B) Positive HIDA scan. Tracer appears in the

duodenum, liver, and common duct but not the gallbladder, suggesting cystic duct obstruc-

tion due to acute cholecystitis.

(Reproduced, with permission, from Hall J, et al. Principles of Critical Care, 3rd ed. New York:

McGraw-Hill, 2005:1258.)