Acute Biliary tract infections, Diagnostic criteria and Treatment

Biliary tract infections, bile duct obstruction include biliary colic,choleocystitis cholangitis,and choleolithiasis are the common health problem worldwide.Twenty-five million adults have gallstones in the United States and 120,000 choleocystomies are performed in U.S. each year. Frequent risk factors include advance age, female sex,pregnancy using estrogen,diabetes,obesity,impacted gallstones, tumors of biliary tree, and bacterial and parasite infection. Women have twice to three times risk of developing gallstones than men, and whites have twice the prevalence of blacks,and Latina women showed higher prevalence than whites Intestinal flora are the frequent cause of acute cholecystitis and acute cholangitis.Severity of acute choleocystitis is classified into mild,grade I,moderate ,gradeII,and severe gradeIII.Diagnosis include clinical presentation,ultrasonography,CTscan,MRIscholangiography,endoscopic retrograde cholangiopancreatographyERCP and, hepato-iminiodiacetic acidHIDA test.Tokyo guidelines for the management of acute cholangitis are heplful.Drugs of choice are the broad spectrum antibiotics such as cefazolin,ceftriaxone,and pipercillin/tazobactam, mainly to cover enteric and anaerobic organisms.Early diagnosis of acute cholecystitis can prevent morbidity and mortality.