CHOLANGITIS
CHOLESTASIS
C
cholangitis
Inflammation of the com-
mon bile duct (see
biliary system).
There
are
2
types: acute ascending cholangitis
and
sclerosing
cholangitis.
Acute
ascending cholangitis is usually due to
bacterial infection of the duct and its
bile, generally as a result of blockage of
the duct by, for example, a gallstone
(see
bile duct obstruction
). The infection
spreads up the duct and may affect the
liver. The main symptoms are recurrent
bouts of jaundice, abdominal pain,
chills, and fever. Mild attacks are treated
with
antibiotics
and a high intake of flu-
ids. In severe, life-threatening attacks,
which may be accompanied by
septi-
caemia
and
kidney failure
, the infected
material may be drained from the bile
duct by surgery or
endoscopy.
Sclerosing cholangitis is a rare condi-
tion in which all the bile ducts within
and outside the liver become narrowed.
The condition causes
cholestasis
, chron-
ic jaundice, and itching of the skin. The
liver is progressively damaged. C
olestyra-
mine
may relieve itching. The only other
treatment available is a
liver transplant
.
chole-
A prefix that means relating to
the
bile
or the
biliary system
.
cholecalciferol
An
alternative
name
for
colecalciferol
, also known as vitamin
D
3
(see
vitamin
D).
cholecystectomy
Surgery to remove the
gallbladder
, usually to deal with
gall-
stones.
Cholecystectomy is also used in
acute
cholecystitis
and as an emergency
treatment for perforation of the gall-
bladder or
empyema.
The procedure is
carried out using conventional surgery
or, more commonly, by
minimally inva-
sive surgery
using a
laparoscope
.
cholecystitis
Acute or chronic inflam-
mation of the
gallbladder
, causing severe
abdominal pain. Acute cholecystitis is
usually caused by a
gallstone
obstruct-
ing the outlet from the gallbladder. The
trapped bile causes irritation of the
gallbladder walls and may become in-
fected by bacteria. The main symptom
is severe constant pain in the right side
of the abdomen under the ribs, accom-
panied
by
fever
and,
occasionally,
jaundice
. Treatment is usually with
anal-
gesic drugs
,
antibiotic drugs
, and an
intravenous infusion of nutrients and
fluids. In some cases, complications
develop, which may include
peritonitis
,
if the gallbladder bursts, and
empyema.
Both require urgent surgical treatment.
Repeated mild attacks of acute chole-
cystitis can lead to a chronic form, in
which the gallbladder shrinks, its walls
thicken, and it ceases to store bile.
Symptoms (indigestion, pains in the
upper abdomen, nausea, and belching)
may be aggravated by eating fatty food.
Cholecystectomy
is the usual treatment.
cholecystography
An X-ray procedure
that uses a
contrast medium
to examine
the
gallbladder
and common
bile duct
,
usually to detect
gallstones.
Cholecys-
tography has largely been replaced by
ultrasound scanning
of the gallbladder.
cholecystokinin
A
gastrointestinal hor-
mone
produced in the
duodenum
in
response to the ingestion of fats and
other food substances. It stimulates the
release of bile from the
gallbladder
and
digestive enzymes from the
pancreas
,
thus facilitating the digestive process.
cholera
An infection of the small intes-
tine by the bacterium
vibrio cholerae
causing profuse watery diarrhoea, which
can lead to dehydration and death.
Infection is acquired by ingesting con-
taminated food or water. Outbreaks of
cholera occur regularly in northeast India,
but worldwide the disease is controlled
by sanitation. Treatment is with water
containing salts and sugar (see
oral
rehydration therapy
) and, in severe cases,
intravenous infusion.
Antibiotic drugs
can shorten the period of diarrhoea and
infectiousness. With adequate rehydra-
tion, affected people usually make a full
recovery from the infection.
cholestasis
Stagnation of
bile
in the
small
bile ducts
within the liver, leading
to
jaundice
and liver
disease.
The
obstruction to the flow of bile may be
intrahepatic (within the liver) or extra-
hepatic (in the bile ducts outside the
liver). Intrahepatic cholestasis may occur
as a result of viral hepatitis (see
hepati-
tis, viral
) or as a side effect of a number
of drugs. The flow of bile improves grad-
ually as the inflammation from the
hepatitis resolves or the drug is discon-
tinued. The bile ducts outside the liver
can become obstructed by, for example,
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