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Biliary Tract Infections

The biliary tract system consists of the liver, gall bladder and the bile ducts. Along with the liver, the gall bladder and the bile ducts produce the bile. This bile consist of water, electrolytes, cholesterol, phospholipids, conjugated bilirubin as well as bile acids.

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Biliary tract infections are often caused by bacteria leading to many painful conditions.

This article will discuss some of these conditions that come under the biliary tract infections.

What are Biliary Tract Infections?

Diseases of the gall bladder and the bile ducts are considered as biliary tract infections. These infections commonly cause acute and chronic abdominal pain syndromes.

The bacteria that commonly leads to biliary tract infection includes Escherichia coli, Klebsiella, Enterobacter, and enterococci. In some cases, Clostridium perfringens can also lead to complications of the biliary tract like sepsis and emphysematous cholecystitis.

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Diseases of the Biliary Tract

Diseases that come under the biliary tract infections include:

Cholelithiasis:

Also called as gallstones, it is a crystalline concretion of the bile components. The gallstones present in the gallbladder can lead to cholecystitis. Gallstones is often called as ‘silent stones’ as the condition may remain asymptomatic for many years. Some of the symptoms of gallstones include intense pain in the upper-right side of the abdomen, nausea, vomiting as well as referred pain between the shoulder blades.

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This condition is caused by a combination of factors like body weight, gallbladder movement, diet, etc. An ultrasound may help detect gallstones.

The treatment for gallstones include by use of medication like oral ursodeoxycholic acid. In some cases, cholecystectomy may help in elimination of cholelithiasis.

Choledocholithiasis:

This condition occurs when the gallstones are present in the common bile duct. Choledocholithiasis leads to liver cell damage as well as jaundice. Symptoms of choledocholithiasis include jaundice of the skin and eyes, clay-colored stools, fever and chills.

This condition occurs when the stones that are large to obstruct the flow within the common bile duct. Presence of cholelithiasis is the main point considered in diagnosis of Choledocholithiasis. An abdominal ultrasound along with elevated levels of bilirubin in liver function tests determines presence of gallstones in the common bile duct.

The treatment for choledocholithiasis includes Endoscopic retrograde cholangiopancreatography (ERCP) . In most cases, cholecystectomy (removal of gallbladder) helps in prevention of choledocholithiasis.

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Cholangitis:

Acute cholangitis is an infection of the bile duct. It is a life threatening condition and considered a medical emergency. The symptoms of cholangitis include jaundice, fever, abdominal pain in the right upper quadrant, rigors, malaise. The patient may also develop low blood pressure and mental confusion.

The cause of cholangitis is usually bile duct obstruction due to presence of gallstones. In some cases, it includes narrowing of the bile duct, damage to the bile ducts during a previous surgery, tumors of the bile duct, gallbladder, ampulla of Vater, pancreatic cancer or duodenum cancer.

Blood tests such as liver function tests, white blood cell count, elevated C-reactive protein level, etc. help in determining cholangitis. Blood cultures often show bacteria causing infection in more than 35% cases. Other tests include ultrasound, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP).

Treatment usually involves admission to hospital. The patient is kept on IV fluids broad spectrum antibiotics for 7 to 10 days. Endoscopy is carried out for relief from biliary obstruction. ERCP is the most common way to approach the blocked bile duct.

Viral Infections of the Biliary Tract

The above diseases of the biliary tract were caused by bacterial agents. Viruses too can infect the biliary tract and lead to diseases. These infections include:

  • Infection of the biliary tract by Hepatitis C, B, A and E viruses leading cholangitic lesions
  • HIV leading to cholangitis/cholangiopathy

However, viral infections of the biliary tract are less common than the bacterial infections. In most cases, the patient requires hospitalization. Speak to your doctor regarding gallstones and related conditions and get the right treatment for the biliary tract infection, before it turns into a complication.

Written by: healthplus24.com team

Date last updated: February 24, 2016