Primary cholangitis - a chronic, progressive disease of the bile ducts, which carry out the bile from the liver to the intestine.
The liver performs many functions; one of themproducing bile. Bile - a watery fluid that is produced by the liver cells and is important for the digestion of food in the intestine, especially fat and rids the body of toxins. Liver cells secrete bile, which enters the small channels in the liver. Bile flows through the channels in the larger hepatic ducts (intrahepatic bile ducts). Then, the bile flows through the intrahepatic bile ducts of the liver in the extrahepatic bile ducts. From extrahepatic biliary bile flow to the intestine, where it is mixed with food.
In the primary cholangitis, intrahepatic andextrahepatic bile ducts begin to become inflamed, injured and sealing, shrink, and finally, there is obstruction of the ducts. ductal obstruction can cause abdominal pain, itching, jaundice, infection in the bile ducts (cholangitis) and scarring of the liver which lead to cirrhosis and liver failure.
Most patients with early primary cholangitis has no presence of the disease symptoms and can only be determined by a blood test.
Early symptoms of primary cholangitis - fatigueand itching. As the disease progresses, patients may develop jaundice. It manifests itself in yellow color of the skin and whites of the eyes. The cause of itching is not fully known.
When developing the primary cholangitis, patients usually complain of abdominal pain, fever, fatigue, itching and jaundice.
To determine cholangitis patients will have blood tests and urine tests, as well as undergo a series of examinations.
Endoscopic retrogradecholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography usually performed to see the intrahepatic and extrahepatic ducts and their narrowing. During the ERCP, a thin tube is inserted in place of the output channels, and then there is injected a contrast agent. To perform Endoscopic cholangiography can also take samples for examination of cells. Also during the examination the doctor may insert a stent (expanders) in the main areas of narrowing.
The main treatment of cholangitis - drugs, relieves itching, and antibiotics.
In severe cases, the surgeon needs help. It can be inserted into the tapered dilators ducts during ERCP, and if such ducts are many, we have to decide on the liver transplant.