Ascending cholangitis

Ascending cholangitis, also called acute cholangitis or simply cholangitis, is inflammation of the bile duct, usually caused by bacteria that travel up from the point where the duct meets the duodenum. It tends to occur when the bile duct is already partly blocked, most often by gallstones. The illness can be life-threatening and is treated as a medical emergency. Typical features are yellowing of the skin or the whites of the eyes, fever and abdominal pain, and in severe cases low blood pressure and confusion. Initial treatment is intravenous fluids and antibiotics, and an underlying gallstone or narrowing of the duct often needs further tests and, usually, endoscopy to relieve the obstruction.