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Conditions We Treat: Cholangitis

Cholangitis is an inflammation of the bile ducts in the liver, most commonly due to a blockage, which causes infection. The blockage may be caused by gallstones, strictures (narrowing), parasites or tumors.

Cholangitis is most often a temporary problem, but some forms of cholangitis are chronic (long-term.) Cholangitis can affect the very small bile ducts or the large ones. Acute blockage of the large bile ducts can be a medical emergency, and may require hospitalization.

Cholangitis Treatment: Why Choose Johns Hopkins

  • We have expertise in new therapies, including FDA-approved obeticholic acid to treat primary biliary cholangitis, and are involved in clinical trials for emerging treatments.
  • The specialists at our center have additional training and experience in managing diseases of the liver, and are skilled at diagnosis and treatment of even the most challenging liver diseases.
  • Our team collaborates with internationally recognized advanced endoscopists and interventional radiologists for treating obstructed bile ducts.

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Cholangitis Treatment at Johns Hopkins: What to Expect

Before Your Appointment

Before we schedule your appointment at our clinic, we will ask you to fax all your records to 410-500-4257. This includes any test results, imaging studies and notes from other doctors.

Examination and Testing

At your appointment, your doctor will ask you questions and perform an examination. He or she may order tests such as:

  • A complete blood test, which can detect the presence of infection.
  • A comprehensive metabolic blood test to examine liver and kidney function.
  • Imaging tests such as ultrasound, CT scan or a special kind of MRI used to detect gallstones.
  • Endoscopic retrograde cholangiopancreatography or ERCP.
  • Other tests as needed. A liver biopsy may not be necessary in all cases, since our team has experience in less invasive ways to detect liver changes that indicate progression of disease.

Treatment for Cholangitis

Once the doctors diagnose cholangitis, you will be treated right away. Your doctors may recommend treatment with intravenous antibiotics in the hospital.

ERCP can be used to drain the fluid from the bile duct and identify what is blocking it. Drains or stents may be surgically placed in the bile duct(s) to keep them open.

More involved surgery may be called for; your doctor will discuss your treatment plan with you.

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