Depending on the type of inflammation distinguish catarrhal, purulent, necrotizing diphtheritic and cholangitis.
When catarrhal cholangitis usually occurs swellingmucosa of the bile ducts. If this is not treated, the inflammation will already be chronic with the formation of scars in the ducts and a further narrowing of the ducts themselves.
Necrotizing cholangitis usually occurs duethat fall into the bile ducts pancreatic enzymes. Due to the impact of these enzymes are formed by sections of tissue necrosis of the biliary tract mucosa.
As for suppurative cholangitis, it often touches together and liver, and gallbladder. In this form of the disease the bile ducts are filled with pus, which is still mixed with bile.
Diphtheritic cholangitis is usually characterized byemergence of ulcers on the mucosa of the biliary tract, whereupon they omertveyut. Thus destroyed wall biliary ducts and the surrounding tissues are purulent fusion.
Depending on the different forms of the disease andits symptoms. Thus, an acute form of the disease usually occurs suddenly. In this case, the patient observed symptoms such as fever up to 40 degrees and chills, severe pain in the right hypochondrium. These pains are somewhat similar to the pain of biliary colic. Pain may occur not only in the region but also spread above, namely, can reach up to the neck and right forearm. Sometimes the pain is given in the right shoulder blade. If intoxication occurs, the patient noted a loss of appetite, general weakness, severe headaches, vomiting and nausea.
In the chronic form of the disease painfeeling generally less pronounced, but if you are in the bile ducts stones, the pain can be quite intense. Also in chronic cholangitis there is a general weakness, pruritus, fatigue, and can periodically increase the temperature. In addition, these patients often marked thickening of the fingertips and redness of the palms.
In order to diagnose the disease,patients received procedures such as ultrasonography (US) of the liver, computed tomography, magnetic resonance cholangiography, the general analysis of blood and urine biochemistry, feces analysis on helminth eggs. Furthermore, for the diagnosis of the disease duodenal intubation is used, which is conducted in order to investigate the bile determine and identify the causative agent of antibiotic sensitivity of the pathogen, which helps in the selection of treatment. In addition, for the diagnosis of cholangitis often used endoscopic retrograde holangipankreatografiya.
In acute cholangitis treatment of the diseasemust be performed in a hospital. In this case the patient should be under constant medical supervision. After all, such a patient is high risk of the need for surgery.
Treatment is generally selected by the physician accordingon the degree of violation of the outflow of bile. Therefore, we use both conservative and surgical methods of treatment. Thus, medical therapy is performed only when the outflow of bile from the gall bladder there is no mechanical obstruction, such as stones. To eliminate inflammation appointed broad-spectrum antibiotics from the tetracycline. Also, antibiotics are used from the group of sulfonamides. Such drugs are generally administered intravenously or intramuscularly. Normally, cholangitis treated with antibiotics continues for at least ten days. Many patients to remove toxins from the body requires a special detoxification therapy. The best method is to use a 5% glucose solution and physiological saline reopoliglyukina, which is administered intravenously.
Patients with an acute form of the disease are appointedantispasmodics, which help to avoid stagnation of bile in the gallbladder and its ducts. In addition, enzyme preparations prescribed to improve digestion. If the patient concerned about severe pain, he selected antibiotics. Pain in cholangitis may be similar to the renal or hepatic colic.
For the treatment of chronic forms of cholangitis in the periodremission appointed physiotherapy treatments such as the UHF-therapy and diathermy. In addition, such patients shows the various heat treatments carried out in many sanatoriums. It will be useful therapeutic exercise. When conservative treatment does not allow to achieve a significant improvement of the patient, discusses the need for surgical treatment. Today, more often as a surgical treatment of cholangitis used endoscopic procedure.