Help the development of the site, sharing the article with friends!

Inflammation of the bile ducts (ducts) is a serious disease that can lead to cirrhosis of the liver, liver failure, or the development of cancer of the bile ducts for which prognosis is poor. What are the causes and symptoms of inflammation of the bile ducts (ducts)? What is the treatment?

Inflammation of the bile ductsis inflammation of the ducts located outside the liver, collecting bile within the liver and draining bile from the liver into the duodenum. As a result of inflammation, the bile ducts are destroyed and narrowed, and then bile stagnates in them. Damage to liver cells can be a consequence of this condition.

Inflammation of the bile ducts (ducts) - causes

1) Primary Sclerosing cholangitis (PSC)

It is an autoimmune disease, i.e. one in the course of which the body - for unknown reasons - attacks itself. Nearly 70 percent patients are diagnosed with inflammatory bowel disease, most often ulcerative colitis, less often Crohn's disease. The disease can develop at any age, but most often it affects men between the ages of 30 and 50 (men get sick twice as often as women). PSC is a rare cause of inflammation of the internal hepatitis and accounts for about 10% of the liver's disease. all cases.

2) Secondary cholangitis. It accounts for about 90 percent. all cases of inflammation of the bile ducts, the causes of which may be:

  • cholelithiasis ( although this may also be a consequence of PSC)
  • pancreatitis
  • biliary tract surgery
  • abdominal injuries
  • liver transplant (as a complication after this procedure)
  • use of certain medications, e.g. vasopressors (drugs that increase blood pressure), chlorpromazine (a drug used in psychiatry)
  • biliary tract infection - bacteria, viruses or parasites

In the latter case, it is mentioned, inter alia, recurrent purulent cholangitis. The disease is associated with parasitic infections and occurs mainly in Southeast Asia, especially in rural areas. The parasites responsible for the disease enter the human digestive tract throughconsumption of infected water or raw fish meat.

Inflammation of the bile ducts - symptoms

Symptoms of bile duct (PSC) inflammation are:

Initially, the disease is asymptomatic and is usually detected accidentally in tests performed for another reason.

  • fatigue
  • itchy skin, which is especially troublesome at night
  • pain in the upper right abdomen
  • jaundice, i.e. a yellowish discoloration of the skin, sclera, conjunctiva, mucous membranes
  • weight loss
  • liver enlargement
  • ascites may also appear and hemorrhage from esophageal varices

Besides, the following appear:

  • fever
  • chills
  • general weakness

Inflammation of the bile ducts - diagnosis

If cholangitis is suspected, the level of liver enzymes and bilirubin are tested (in the case of the disease it is elevated). Final diagnosis is made on the basis of the image of the bile ducts visualized by magnetic resonance cholangiography (MRCP for short) or endoscopic retrograde cholangiopancreatography (ERCP).

Cholangitis - treatment

For primary sclerosing cholangitis (PSC), complete healing is impossible. The disease is progressive and leads to cirrhosis and death from complications, or, as mentioned earlier, to the development of bile duct cancer. 1 It develops in 6-20% of patients. sick. Due to the still unknown causes of PSC, various treatments have been tried as research into the disease progressed. They can be divided into:

  • drug administration (ursodeoxycholic acid, which reduces the activity of enzymes, GGTP and AP, and also relieves itchy skin)
  • endoscopic treatment (during which the narrowed tubes expand)
  • surgical treatment (if endoscopic treatment is ineffective)

In advanced stages of PSC and in cases of suspected biliary cancer, liver transplantation is indicated.

In cases of secondary bile duct inflammation, the goal of treatment is to remove the cause of the disease. For example, in the case of cholelithiasis, the treatment consists of removing the remaining stones. In turn, in the case of a bacterial infection, antibiotics are given.

Source:

1. Habior A., ​​Primary sclerosing cholangitis - diagnosis and treatment,"Clinical Gastroenterology" 2010

Help the development of the site, sharing the article with friends!

Category:

Research