THE PATHOGENESIS OF BACTERIAL CHOLANGITIS

Acute cholangitis is a well-known complication in patients with biliar y tract obstruction. Bacteria reach the biliary tract either by ascend ing through an incompetent sphincter of Oddi, or by translocation from the gut. Several mechanisms in bile act to eliminate the invading org anisms, but in jaundiced patients these mechanisms may be compromised. When, secondary to obstruction, biliary pressure rises, bacteria can leak from the bile into the systemic circulation and cause septicaemia and clinical symptoms of cholangitis. Here we review the most importa nt factors in the pathogenesis of acute cholangitis.