Ascending cholangitis causes

Any condition that leads to stasis or obstruction of bile in the common bile duct can lead to bacterial infection and cholangitis. Most common causes include bile duct stones and benign or malignant strictures. Less common causes include parasitic infection, malignancy, or extrinsic compression by the pancreas. Partial obstruction has a higher rate of infection as compared to complete obstruction

Ascending Cholangitis results from a bacterial infection that is usually due to the bile stasis following a chronic obstruction. Some of the causes leading to ascending cholangitis are mentioned below.^[1][2]

The most common causes of ascending cholangitis include:^[3]

• Choledocholithiasis / Common bile duct stones
• Benign Stenosis or strictures
  • Post surgical
  • Chronic pancreatitis
  • Radiation induced
• Malignant Stenosis/Obstruction
  • Cholangiocarcinoma
  • Pancreatic cancer
  • Gall bladder cancer
  • Ampullary cancer
• Iatrogenic
  • Following ERCP
  • Post-operative biliary strictures

• Parasitic infections
  • Ascaris lumbricoides
  • Clonorchis sinensis
  • Opisthorchis viverrini
  • Ogatpisthorchis felineus
  • Taenia saginata
• Malignancy^[4]
  • Hepatoma
  • Lymphoma
  • Metastasis to bile duct
• Sclerosing cholangitis
• Congenital causes
  • Caroli Syndrome – rare disorder of intrahepatic bile duct
• Lemmel syndrome
  • An obstructive jaundice syndrome due to a duodenal diverticulum which can displace or compress the bile duct or pancreatic duct opening leading to biliary obstruction and stasis
• Mirizzi Syndrome
  • Common bile duct obstruction due to external compression by stones in cystic duct and gallbladder neck

The infecting organisms are usually gram-negative bacilli (eg, E. coli, Klebsiella, Pseudomonas, Bacteroides and Enterococcus).^[5]

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