Chronic infections of the biliary system

Chronic inflammation of the gallbladder and the biliary tract due to infect ions are rare, compared to common cholelithiasis and acute biliary inflamma tion. This group of diseases includes, besides of chronic cholecystitis wit h cholelithiasis, also chronic gallbladder inflammation without stones, gal lbladder hydrops and porcellain gallbladder. The most common form of chroni c biliary tract infection is primary sclerosing cholangitis, while infectio n due to parasites like oriental cholangiohepatitis is Very rare in Europe. Using imaging modalities like ultrasonography, computed tomography and mag netic resonance imaging, normally, besides of porcellain gallbladder, only indirect signs of the disease may be documented. However, when iv cholangio graphy, endoscopic-retrograde cholangiography, percutane transhepatic chola ngiography or MR-cholangiography are performed, depiction, especially of th e biliary tree, is feasible. Differentiation of benign stricture and malign ant tumor stenosis is problematic unrelated to the imaging modality used. D ue to the unspecific signs of the disease,diagnosis may not be made from im aging alone, but a clinical suspicion may be strengthened.