Cholangitis risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2], Farwa Haideri [3]

The common risk factors in the development of cholangitis are dilatation of common bile duct, CBD stones, gallstones, sclerosing cholangitis, and HIV.

Common risk factors in the development of cholangitis include:^[1][2][3][4]

• Surgery of the biliary tract^[5]
• Dilatation of common bile duct (CBD)
• Previous history of gallstones
• Large CBD stones
• A history of sclerosing cholangitis
• Advanced age (>70 years of age)
• Procedure like ERCP^[6]

Less common risk factors in the development of cholangitis include:^[1][2][3][4]

• HIV
• Neurologic disease
• Narrowing of the common bile duct due to cancer
• Traveling to countries where you might catch a worm or parasite infection
• Presence of liver abscess
• Acute renal failure
• Periampullary diverticula

The bile of healthy individuals is generally aseptic.^[7]

• Bile culture is positive for microorganisms in:
  • 16% of patients undergoing a non-biliary operation
  • 72% of acute cholangitis patients
  • 44% of chronic cholangitis patients
  • 50% of patients with biliary obstruction
• The bacteria in bile are identified in 90% of patients with choledocholithiasis, accompanied by jaundice.
• Patients with incomplete obstruction of the bile duct present with a higher positive bile culture rate than those with complete obstruction of the bile duct.^[7]

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