Cholangitis

- Diagnostic features include:

• fever/rigors
• elevated CRP and WBC
• cholestasis – jaundice (clinically evident or increased total bilirubin) and/or abnormal liver enzymes (ALT, AST, ALP, GGT)
• imaging suggestive of cholangitis:
  • abdominal ultrasound findings - biliary duct dilatation, stones.  Test sensitivity is not high.
  • contrast-enhanced CT findings - biliary duct dilatation, stenosis, stones.
  • MRCP – high sensitivity and specificity for acute cholangitis.

- Decompression of biliary tree is necessary in most cases. ERCP should be done within 48 hours of clinical presentation