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Acute Cholangitis without Biliary Obstruction: Causes and Radiologic Features  

Jo, Jung-Hyun (Department of Radiology, Dong-A University, College of Medicine)
Kwon, Hee-Jin (Department of Radiology, Dong-A University, College of Medicine)
Kang, Myong-Jin (Department of Radiology, Dong-A University, College of Medicine)
Yoon, Seong-Kuk (Department of Radiology, Dong-A University, College of Medicine)
Cho, Jin-Han (Department of Radiology, Dong-A University, College of Medicine)
Publication Information
Journal of the Korean Society of Radiology / v.62, no.6, 2010 , pp. 533-540 More about this Journal
Abstract
Purpose: The aim of this study is to determine the causes of acute cholangitis without the biliary obstruction and radiological findings. Materials and Methods: This study was performed retrospectively. A total of 135 patients diagnosed with acute cholangitis in a clinical setting based on the review of the radiologic findings from an ultrasonogram (USG), computed tomogram (CT), or magnetic resonance images (MRI). Among them, patients with a biliary obstruction as a result of a stone, tumor, lymph node, stricture were excluded. A total of 31 patients had acute cholangitis without a definite biliary obstruction. We analyzed their causes and imaging features with the USG and CT image. Results: The causes of acute cholangitis without biliary obstruction included Clonorchis sinensis cholangitis in 15 cases (48%), post-operative swelling after gastrojejunostomy, pylorus preserved partial duodenectomy, and choledochojejunostomy in 7 cases (22.6%), recent spontaneous passage of a distal CBD stone in 3 cases (9.7%), compression effect by the large duodenal diverticulum in 2 cases (6.5%), and unknown causes in 4 cases (12.9%). Conclusion: Acute cholangitis may be associated without a distal biliary obstruction. USG, CT, or MR imaging can provide precise information as well as help to differentiate the causes of acute cholangitis.
Keywords
Biliary Track Diseases; Cholangitis; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Ultrasonogrpahy; Acute Diseases;
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