Incidence
Age
Sex
Geography
Aetiology	- baterial infection of bile ducts, always secondary to bile duct abnormalities Common causes - CBD stones - biliary strictures - neoplams - following ERCP in the presence of large duct obstruction
Presentation	History - fever, often with rigors - upper abdominal pain - jaundice (all of the above present in 70%)
Investigations	FBC - leucocytosis Blood cultures - usually E. coli
Macro
Micro
Staging
Serum markers
Management	Medical - i.v. amoxycillin 1g 6 hourly - i.v. gentamicin 2-5 mg/kg daily in divided doses (severe cases) - ceftazidime Surgical - complications may require urgent decompression of duct; usually endoscopic with placement of nasobiliary drain - subsequent treatment is endoscopic or surgical
Prognosis
Complications	Suppurative cholangitis - fever continues and shock develops despite adequate antibiotic treatment - requires urgent decompression

Hepatobiliary medicine

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