Epidemiology

Acute cholangitis is relatively uncommon, presenting as a complication in less than 10% of patients admitted to hospital with cholelithiasis.[8] Male-to-female ratio is equal.[9] The average age of presentation is between 50 and 60 years old.[9] Cholangitis is most commonly seen in Latin American and American Indian people.[9] About 0.5% to 2.4% of patients develop cholangitis after endoscopic retrograde cholangiopancreatography, usually due to inadequate steps taken to ensure biliary drainage.[10] Recurrent oriental pyogenic cholangitis is more common in the eastern hemisphere than in the western hemisphere.[11]

Risk factors

Presents more commonly in older people.[16] The average age of presentation is between 50 and 60 years.[9]

Leads to common bile duct obstruction.[10]

Leads to common bile duct obstruction.[10][12]

Leads to common bile duct obstruction.[10][12]

Surgical, endoscopic, or radiologic intervention (e.g., endoscopic retrograde cholangiopancreatography [ERCP], cholecystectomy) can result in inadequate biliary drainage or contamination of the biliary tree, leading to common bile duct stricture and obstruction.[10][12]

Leads to common bile duct stricture and obstruction.[10]

Leads to common bile duct stricture and obstruction.[10]

HIV is a risk factor for cholangitis, but patients with HIV infection also often develop HIV cholangiopathy, which can have similar laboratory findings but a much less acute presentation. Cholangitis in HIV infection is less common with the use of highly active antiretroviral therapy.[17]

Immune checkpoint inhibitors used in the treatment of cancers are associated with gastrointestinal and liver toxicity, including cholangitis.[18][19]

IgG4-related cholangitis is the most common manifestation of IgG4-related hepatobiliary disease.[20]

Use of this content is subject to our disclaimer