Modern imaging of cholangitis

Area of Science:

• Gastroenterology
• Hepatology
• Diagnostic Imaging

Background:

• Cholangitis is bile duct inflammation, classified as acute or chronic based on duration.
• Causes include mechanical obstruction (acute) and immune-mediated damage (chronic).
• Diagnosis relies on clinical presentation, lab tests, and various imaging modalities.

Purpose of the Study:

• To provide an overview of common cholangitis types.
• To emphasize clinical experience with chronic cholestatic liver diseases.
• To detail the diagnostic work-up for cholangitis.

Main Methods:

• Review of medical history and clinical presentation.
• Initial laboratory tests and imaging modalities including ultrasound, CT, and MRCP.
• Endoscopic ultrasound, retrograde cholangiography, and percutaneous transhepatic cholangiography for specific interventions.

Main Results:

• Ultrasound is the first-line imaging for bile duct dilatation.
• MRCP offers excellent anatomical and functional information for biliary disorders.
• Work-up pace is guided by cholestasis severity, with immediate action for sepsis or Charcot's triad.

Conclusions:

• Cholangitis diagnosis and management vary based on acuity and cause.
• Advanced imaging like MRCP is crucial for detailed biliary assessment.
• This review highlights clinical insights into chronic cholestatic liver diseases.