Cholangitis
Cholangitis was first defined in 1877 by Jean-Martin Charcot, who described the pathognomonic triad of fever, right upper quadrant pain, and jaundice. Today, cholangitis is defined as the presence of increased hepatic intraductal pressure along with concurrent infection of the obstructed bile ducts.
Chole: Derived from the Greek word “cholē,” meaning bile.Angio: Comes from the Greek “angeion,” meaning vessel.
Cholangitis: Refers to a bacterial infection of the biliary tree.
The pathogens most commonly identified as causative agents of acute ascending cholangitis are gram-negative and anaerobic organisms. The most common pathogens include Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, and Citrobacter.
Iatrogenic introduction of bacteria often occurs following endoscopic retrograde cholangiopancreatography (ERCP) in individuals with biliary obstruction.
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Charcot's Triad: The classical triad (fever, right upper quadrant pain, and jaundice) has high specificity (95.9%) but low sensitivity (26.4%).
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Tokyo Guidelines (2018): The sensitivity of the Tokyo guidelines is 100%, with a specificity of 87.4%.
