Hello! I have been a doctor for 21 years. My name is Georgy Olegovich Sapego. In this article I will talk about cholangitis.
Inflammation of the bile ducts is called cholangitis. It manifests itself with high fever, jaundice and abdominal pain. Sometimes this thing is greasy, and sometimes cholangitis can kill you.
What "blurry flow"? Well, this is when there are no sharp peaks in temperature or pain. As if all of the above disgrace was smeared with a thin, even layer.
What is needed for this
If you want to get acute cholangitis, then you need some kind of infection and bile stasis at the same time.
Usually the infection rises into the bile duct from the duodenum. If you try very hard, you can populate microbes from the portal vein. You can read about how all the filth flies into the liver from the portal vein in my article about fluid in the stomach.
The most important thing in this matter is the stagnation of bile. It happens because of stones in the biliary tract, oncology and any unpleasant individual characteristics of the ducts.
How microbes enter the biliary tract
In fact, there are many natural barriers that are difficult for microbes to crawl through.
The first barrier is Oddi's beloved sphincter. It is like a door from the liver to the intestines - it releases bile, but does not let anything back in.
In addition, bile flows like a river, and it is difficult for microbes to fight this stormy flow.
And bile itself is quite caustic. Not every microbe survives in it.
The last line of defense in the biliary tract is secretory antibodies and mucus.
We have already said that most of the antibodies in the body does not float in blood, and is secreted outward by various glands. They sit on mucous membranes and, like ants next to an anthill, attack everything that crawls by.
Slime too helps resist infection. It acts like a network that catches uninvited guests.
Stagnation of bile
Everything is simple here. The liver constantly secretes bile. Liver cells work in three shifts and secrete bile in a continuous flow. They are so busy with the production process that they have absolutely no interest in transporting and promoting their products. And in vain. Because when obstacles appear in the path of this flow, pressure in the biliary tract rises. It rises to such an extent that bile will enter the bloodstream. It turns out jaundice.
The bad news is that microbes are literally imprinted into the wall of the bile ducts under high pressure. No mucus will bother them. This is how the infection begins. If you're unlucky, the germs will continue to enter the bloodstream.
We treat one, we cripple the other
Sometimes we ourselves open the door for germs. It happens that you have to rip out stones from the common bile duct, put stents on the narrowed bile duct (yes, literally, like in the heart). All this violates natural defense mechanisms.
In addition to the fact that medical instruments break the door to the liver, the stones themselves with stents turn into a dormitory for microbes. Bacteria easily organize colonies there and then, at some point, arrange a hotbed of infection.
This case was specially checked, and it turned out that in people with normal patency of the bile ducts bile is sterile, but if a stone sits somewhere and slightly interferes, then in 70% of cases there will be microbes.
How it starts
There are 3 classic symptoms of cholangitis:
- high fever (and even with chills);
- abdominal pain;
- jaundice.
Approximately 50 - 75% of patients complain about everything at once.
When something festers in that place, people very quickly become weak and loaded. Severe cholangitis can be deadly.
This is all about the question of gallstones and what to do with them. Someone gets used to pain in the right hypochondrium and then later calls an ambulance. Therefore, do not delay and be sure to consult a doctor in any suspicious situation.
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