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Ascending Cholangitis
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

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

              • Pyogenic infection of biliary tree as result of biliary obstruction

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Fluoroscopic Findings

                    • Ultrasonographic Findings

                      • Nonvascular Interventions

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Malekzadeh S et al: Typical imaging finding of hepatic infections: a pictorial essay. Abdom Radiol (NY). 46(2):544-61, 2020
                                              2. Arslan MF et al: MR cholangiopancreatography findings of biliary tract complications after liver transplantation Turk J Med Sci. 48(5):1006-12, 2018
                                              3. O'Connell W et al: Obstruction of the biliary and urinary system. Tech Vasc Interv Radiol. 20(4):288-93, 2017
                                              4. Costello JR et al: MR imaging of benign and malignant biliary conditions. Magn Reson Imaging Clin N Am. 22(3):467-88, 2014
                                              5. Kochar R et al: Infections of the biliary tract. Gastrointest Endosc Clin N Am. 23(2):199-218, 2013
                                              6. Patel NB et al: Multidetector CT of emergent biliary pathologic conditions. Radiographics. 33(7):1867-88, 2013
                                              7. Lee NK et al: MR appearance of normal and abnormal bile: correlation with imaging and endoscopic finding. Eur J Radiol. 76(2):211-21, 2010
                                              8. Catalano OA et al: Biliary infections: spectrum of imaging findings and management. Radiographics. 29(7):2059-80, 2009
                                              9. Kim SW et al: Transient arterial enhancement of the hepatic parenchyma in patients with acute cholangitis. J Comput Assist Tomogr. 33(3):398-404, 2009
                                              10. Lee JG: Diagnosis and management of acute cholangitis. Nat Rev Gastroenterol Hepatol. 6(9):533-41, 2009
                                              11. Lee NK et al: Discrimination of suppurative cholangitis from nonsuppurative cholangitis with computed tomography (CT). Eur J Radiol. 69(3):528-35, 2009
                                              12. Salek J et al: Analysis of risk factors predictive of early mortality and urgent ERCP in acute cholangitis. J Clin Gastroenterol. 43(2):171-5, 2009
                                              13. Yeh BM et al: MR imaging and CT of the biliary tract. Radiographics. 29(6):1669-88, 2009
                                              14. Attasaranya S et al: Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis. Med Clin North Am. 92(4):925-60, x, 2008
                                              15. Kinney TP: Management of ascending cholangitis. Gastrointest Endosc Clin N Am. 17(2):289-306, vi, 2007
                                              16. Watanabe Y et al: MR imaging of acute biliary disorders. Radiographics. 27(2):477-95, 2007
                                              17. Hanbidge AE et al: From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 24(4):1117-35, 2004
                                              18. Arai K et al: Dynamic CT of acute cholangitis: early inhomogeneous enhancement of the liver. AJR Am J Roentgenol. 181(1):115-8, 2003
                                              19. Browning JD et al: Gallstone disease and its complications. Semin Gastrointest Dis. 14(4):165-77, 2003
                                              20. HÃ¥kansson K et al: MR characteristics of acute cholangitis. Acta Radiol. 43(2):175-9, 2002
                                              21. Bader TR et al: MR imaging findings of infectious cholangitis. Magn Reson Imaging. 19(6):781-8, 2001
                                              22. Hanau LH et al: Acute (ascending) cholangitis. Infect Dis Clin North Am. 14(3):521-46, 2000
                                              23. Song HH et al: Eosinophilic cholangitis: US, CT, and cholangiography findings. J Comput Assist Tomogr. 21(2):251-3, 1997
                                              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

                                                        TERMINOLOGY

                                                        • Synonyms

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

                                                          • Pyogenic infection of biliary tree as result of biliary obstruction

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Fluoroscopic Findings

                                                                • Ultrasonographic Findings

                                                                  • Nonvascular Interventions

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Malekzadeh S et al: Typical imaging finding of hepatic infections: a pictorial essay. Abdom Radiol (NY). 46(2):544-61, 2020
                                                                                          2. Arslan MF et al: MR cholangiopancreatography findings of biliary tract complications after liver transplantation Turk J Med Sci. 48(5):1006-12, 2018
                                                                                          3. O'Connell W et al: Obstruction of the biliary and urinary system. Tech Vasc Interv Radiol. 20(4):288-93, 2017
                                                                                          4. Costello JR et al: MR imaging of benign and malignant biliary conditions. Magn Reson Imaging Clin N Am. 22(3):467-88, 2014
                                                                                          5. Kochar R et al: Infections of the biliary tract. Gastrointest Endosc Clin N Am. 23(2):199-218, 2013
                                                                                          6. Patel NB et al: Multidetector CT of emergent biliary pathologic conditions. Radiographics. 33(7):1867-88, 2013
                                                                                          7. Lee NK et al: MR appearance of normal and abnormal bile: correlation with imaging and endoscopic finding. Eur J Radiol. 76(2):211-21, 2010
                                                                                          8. Catalano OA et al: Biliary infections: spectrum of imaging findings and management. Radiographics. 29(7):2059-80, 2009
                                                                                          9. Kim SW et al: Transient arterial enhancement of the hepatic parenchyma in patients with acute cholangitis. J Comput Assist Tomogr. 33(3):398-404, 2009
                                                                                          10. Lee JG: Diagnosis and management of acute cholangitis. Nat Rev Gastroenterol Hepatol. 6(9):533-41, 2009
                                                                                          11. Lee NK et al: Discrimination of suppurative cholangitis from nonsuppurative cholangitis with computed tomography (CT). Eur J Radiol. 69(3):528-35, 2009
                                                                                          12. Salek J et al: Analysis of risk factors predictive of early mortality and urgent ERCP in acute cholangitis. J Clin Gastroenterol. 43(2):171-5, 2009
                                                                                          13. Yeh BM et al: MR imaging and CT of the biliary tract. Radiographics. 29(6):1669-88, 2009
                                                                                          14. Attasaranya S et al: Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis. Med Clin North Am. 92(4):925-60, x, 2008
                                                                                          15. Kinney TP: Management of ascending cholangitis. Gastrointest Endosc Clin N Am. 17(2):289-306, vi, 2007
                                                                                          16. Watanabe Y et al: MR imaging of acute biliary disorders. Radiographics. 27(2):477-95, 2007
                                                                                          17. Hanbidge AE et al: From the RSNA refresher courses: imaging evaluation for acute pain in the right upper quadrant. Radiographics. 24(4):1117-35, 2004
                                                                                          18. Arai K et al: Dynamic CT of acute cholangitis: early inhomogeneous enhancement of the liver. AJR Am J Roentgenol. 181(1):115-8, 2003
                                                                                          19. Browning JD et al: Gallstone disease and its complications. Semin Gastrointest Dis. 14(4):165-77, 2003
                                                                                          20. HÃ¥kansson K et al: MR characteristics of acute cholangitis. Acta Radiol. 43(2):175-9, 2002
                                                                                          21. Bader TR et al: MR imaging findings of infectious cholangitis. Magn Reson Imaging. 19(6):781-8, 2001
                                                                                          22. Hanau LH et al: Acute (ascending) cholangitis. Infect Dis Clin North Am. 14(3):521-46, 2000
                                                                                          23. Song HH et al: Eosinophilic cholangitis: US, CT, and cholangiography findings. J Comput Assist Tomogr. 21(2):251-3, 1997