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Ultrasound
Diagnosis
Biliary System
Ductal Pathology
Ascending Cholangitis
Ascending Cholangitis
Justin Ruey Tse, MD; Aya Kamaya, MD, FSRU, FSAR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Bacterial cholangitis, acute obstructive cholangitis, suppurative cholangitis, biliary infection

              • Definitions

                • Inflammation of intra-/extrahepatic bile duct walls due to ductal obstruction and bile superinfection

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • Radiographic Findings

                    • CT Findings

                      • MR Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Tse JR et al: Does measurement of the hepatic artery velocity improve the sonographic diagnosis of cholangitis? Abdom Radiol (NY). 44(12):4004-10, 2019
                                                2. Kiriyama S et al: Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 25(1):17-30, 2018
                                                3. Spârchez Z et al: Role of contrast enhanced ultrasound in the assessment of biliary duct disease. Med Ultrason. 16(1):41-7, 2014
                                                4. Patel NB et al: Multidetector CT of emergent biliary pathologic conditions. Radiographics. 33(7):1867-88, 2013
                                                5. Eun HW et al: Assessment of acute cholangitis by MR imaging. Eur J Radiol. 81(10):2476-80, 2012
                                                6. Kim SW et al: Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method. Br J Radiol. 85(1014):770-7, 2012
                                                7. Ciocirlan M et al: Diagnostic endoscopic retrograde cholangiopancreatography. Endoscopy. 36(2):137-46, 2004
                                                8. Kiriyama S et al: TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 20(1):24-34, 2013
                                                9. Arai K et al: Dynamic CT of acute cholangitis: early inhomogeneous enhancement of the liver. AJR Am J Roentgenol. 181(1):115-8, 2003
                                                10. Baron RL et al: Imaging the spectrum of biliary tract disease. Radiol Clin North Am. 40(6):1325-54, 2002
                                                11. Menu Y et al: Non-traumatic abdominal emergencies: imaging and intervention in acute biliary conditions. Eur Radiol. 12(10):2397-406, 2002
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Synonyms

                                                              • Bacterial cholangitis, acute obstructive cholangitis, suppurative cholangitis, biliary infection

                                                            • Definitions

                                                              • Inflammation of intra-/extrahepatic bile duct walls due to ductal obstruction and bile superinfection

                                                            IMAGING

                                                            • General Features

                                                              • Ultrasonographic Findings

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Tse JR et al: Does measurement of the hepatic artery velocity improve the sonographic diagnosis of cholangitis? Abdom Radiol (NY). 44(12):4004-10, 2019
                                                                                              2. Kiriyama S et al: Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 25(1):17-30, 2018
                                                                                              3. Spârchez Z et al: Role of contrast enhanced ultrasound in the assessment of biliary duct disease. Med Ultrason. 16(1):41-7, 2014
                                                                                              4. Patel NB et al: Multidetector CT of emergent biliary pathologic conditions. Radiographics. 33(7):1867-88, 2013
                                                                                              5. Eun HW et al: Assessment of acute cholangitis by MR imaging. Eur J Radiol. 81(10):2476-80, 2012
                                                                                              6. Kim SW et al: Diagnostic performance of multidetector CT for acute cholangitis: evaluation of a CT scoring method. Br J Radiol. 85(1014):770-7, 2012
                                                                                              7. Ciocirlan M et al: Diagnostic endoscopic retrograde cholangiopancreatography. Endoscopy. 36(2):137-46, 2004
                                                                                              8. Kiriyama S et al: TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 20(1):24-34, 2013
                                                                                              9. Arai K et al: Dynamic CT of acute cholangitis: early inhomogeneous enhancement of the liver. AJR Am J Roentgenol. 181(1):115-8, 2003
                                                                                              10. Baron RL et al: Imaging the spectrum of biliary tract disease. Radiol Clin North Am. 40(6):1325-54, 2002
                                                                                              11. Menu Y et al: Non-traumatic abdominal emergencies: imaging and intervention in acute biliary conditions. Eur Radiol. 12(10):2397-406, 2002