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Aetiology of acute cholecystitis

Authoring team

Biliary obstruction in acute cholangitis is frequently caused by choledocholithiasis. Other causes of acute cholangitis include:

  • benign biliary stricture
  • congenital factors
  • post-operative factors (damaged bile duct, strictured choledojejunostomy, etc.)
  • inflammatory factors (oriental cholangitis, etc.)
  • malignant occlusion - bile duct tumor, gallbladder tumor, ampullary tumor, pancreatic tumor
  • duodenal tumor
  • pancreatitis
  • entry of parasites into the bile ducts
  • external pressure
  • fibrosis of the papilla
  • deuodenal diverticulum
  • blood clot
  • sump syndrome after biliary enteric anastomosis
  • iatrogenic factors
    • acute cholangitis may occur as a result of biliary interventions such as endoscopic retrograde cholangiopancreatography (ERCP) and the use of biliary stents

Note:

  • an increase in incidence is reported in malignant disease, sclerosing cholangitis, and non-surgical instrumentation of the biliary tract as causes of acute cholangitis

Reference:

  1. Kimura Y, Takada T, Strasberg SM, et al. TG13 current terminology, etiology, and epidemiology of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):8-23.

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