Risk factors for acute suppurative cholangitis caused by bile duct stones
Takeshi Tsujino1, Reimu Sugita, Haruhiko Yoshida
1Department of Gastroenterology, University of Tokyo, Tokyo, Japan. tsujinot-int@h.u-tokyo.ac.jp
Objective:
Acute suppurative cholangitis is fatal unless adequate biliary drainage is obtained in a timely manner. The major cause of acute suppurative cholangitis is bile duct stones, but it is not known which patients with bile duct stones are likely to develop acute suppurative cholangitis.
Methods:
Between May 1994 and December 2005, 343 consecutive patients with bile duct stones were referred to our department. Of these, 38 patients presented with acute suppurative cholangitis. A nasobiliary catheter or biliary stent was emergently inserted endoscopically to control acute suppurative cholangitis in those patients. Risk factors for the development of acute suppurative cholangitis in the 343 patients were investigated using univariate and multivariate analyses.
Results:
A nasobiliary catheter or stent was inserted endoscopically in all 38 patients with acute suppurative cholangitis. Although biliary drainage was considered to be effective in all patients, two patients (5.3%) died of deteriorating comorbid diseases despite subsiding cholangitis. In the univariate analysis, age >or=70 years, neurological disease, and peripapillary diverticulum were identified as risk factors for the development of acute suppurative cholangitis. In the multivariate analysis, these three factors remained significant.
Conclusions:
Advanced age, comorbid neurological disease, and peripapillary diverticulum were identified as independent risk factors for the development of acute suppurative cholangitis in patients with bile duct stones.
Related Concept Videos
01:20Cholecystitis
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:25Acute Pancreatitis I: Introduction
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:21Chronic Pancreatitis II: Pathophysiology
01:25Chronic Pancreatitis I: Introduction