cholangitis

Definition of cholangitis

chol-angi--itis - inflammation of hepatic bile ducts or cystic bile duct (inflammation of bile duct); Cholangitis is a potentially life-threatening clinical syndrome characterized by inflammation and infection of the bile ducts. The most common form, acute ascending cholangitis, occurs when an obstruction (such as a gallstone, stricture, or tumor) causes bile to become stagnant, leading to a rapid multiplication of bacteria (typically E. coli, Klebsiella, or Enterococcus) that then ascend from the duodenum into the biliary tree. If left untreated, the increased intraluminal pressure can push bacteria into the systemic circulation, leading to sepsis and multi-organ failure.

---

Etymology of cholangitis

greek The term is a composite of three Greek elements:

• chol- (χολή): Root meaning “bile” or “gall.”

• angi- (ἀγγεῖον): Root meaning “vessel” or “duct.”

• -itis (-ῖτις): Suffix denoting “inflammation.”

• Literal Meaning: “Inflammation of the bile vessel.”

---

Coding & Documentation Nuances

• ICD-10-CM: The primary code is K83.01 (Cholangitis). However, it is a “code first” condition if associated with certain underlying causes. If the patient has calculus of the bile duct with cholangitis, the coder must use category K80.3-.

• Sepsis Sequencing: If the patient presents with s[[ystemic inflammatory response syndrome (SIRS)]] due to cholangitis, A41.9 (Sepsis, unspecified organism) may be the principal diagnosis, followed by K83.01 as the localized infection, depending on the circumstances of admission.

• ICD-10-PCS Root Operations: * If a stent is placed to relieve obstruction: Insertion (Putting in a non-biological appliance).

  • If a stone is removed via ERCP: Extirpation (Taking or cutting out solid matter from a body part).

  • If a stricture is widened: Dilation (Expanding an orifice or the lumen of a tubular body part).

Clinical Indicators

Coders should monitor the documentation for Charcot’s Triad or Reynold’s Pentad to support the severity of the diagnosis:

1. Charcot’s Triad: Fever/Chills, Jaundice, and Right Upper Quadrant (RUQ) abdominal pain.

2. Reynold’s Pentad: Charcot’s Triad plus Hypotension (shock) and Altered Mental Status (indicating severe sepsis).

3. Laboratory Data: Elevated total bilirubin, alkaline phosphatase (ALP), and leukocytosis.

4. Imaging: Ultrasound or MRCP showing “biliary tree dilation” or “choledocholithiasis.”

Related Terms & Differentials

• Choledocholithiasis: The presence of a gallstone in the common bile duct; this is often the cause of cholangitis but not the infection itself.

• Cholecystitis: Inflammation of the gallbladder (usually due to a stone in the cystic duct), rather than the bile ducts.

• Primary Sclerosing Cholangitis (PSC): A chronic, autoimmune-mediated inflammation and scarring of the bile ducts, distinct from acute bacterial ascending cholangitis.

• Cholangiography: A diagnostic imaging procedure (like ERCP or PTC) used to visualize the bile ducts.

• Biliary Atresia: A congenital condition where the bile ducts are abnormally narrow, blocked, or absent.

---

DERIVATIONS of cholangitis

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(roots, (word) => econtains([[]].roots, word))) > 0 AND file.name != [[]].file.name
SORT file.name ASC

---

Query functionality

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(definition, (word) => econtains([[]].definition, word))) > 0 AND file.name != [[]].file.name

Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms