Aetiology of acute cholecystitis

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 (1)

Reference:

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