Infection of the bile duct or biliary tree. Usually caused by obstruction of the common bile duct, which is itself most commonly caused by a gallstone impacted in the duct.

The most common bacteria which infect the biliary tree are: E. coli (39%), Klebsiella species (54%), Enterobacter (34%), Enterococci (34%) and group D streptococci. The infection may also be polymicrobial. Bacteria infect the bile directly from the gut (ascending cholangitis) or through the lymphatics or vascular supply.

Cholangitis itself is relatively uncommon in the U.S. but Oriental cholangio-hepatitis is endemic in certain parts of Asia.

Not a good disease to have. The mortality figures are not good.

Treatment is by giving antibiotics.

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