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Recurrent pyogenic cholangitis: a review of imaging findings and clinical management

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Abstract

Recurrent pyogenic cholangitis (RPC) is an infective process involving the biliary tree typified by pigmented intraductal calculi with dilatation of the intra- and extrahepatic biliary tree. Previously endemic to South-east Asia, RPC can now be seen in Western countries with the increasing access to international travel and immigration. Affected patients are often plagued by recurrent bouts of cholangitis, and commonly suffer from complications such as abscess formation and biliary strictures. In severe cases, cirrhosis with portal hypertension may develop. The disease is also a known risk factor for cholangiocarcinoma, and can be seen in up to 5% of affected patients. Its exact etiology is unknown, but parasitic infections such as Clonorchis sinensis and Ascaris lumbricoides, ascending bacterial infection with gut flora (Escherichia coli) and low socioeconomic status have been associated strongly with it. This paper reviews the imaging features of the disease, as well as the roles of interventional radiology and surgery with respect to management of the condition.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore

    Kenneth Eng Ling Kwan & Cher Heng Tan

  2. Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore

    Vishalkumar G. Shelat

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  1. Kenneth Eng Ling Kwan
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  2. Vishalkumar G. Shelat
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Correspondence to Kenneth Eng Ling Kwan.

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This article does not contain any studies with human participants or animals performed by any of the authors. Images were obtained from an educational database. All patient identifiers have been removed.

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Kwan, K.E.L., Shelat, V.G. & Tan, C.H. Recurrent pyogenic cholangitis: a review of imaging findings and clinical management. Abdom Radiol 42, 46–56 (2017). https://doi.org/10.1007/s00261-016-0953-y

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