PAEA Surgery End Of Rotation (EOR) Practice Exam

What are common causes of cholangitis?

1. Pancreatic insufficiency and gallbladder stones

2. Choledocholithiasis and biliary stent

3. Diverticulitis and ulcerative colitis

4. Appendicitis and peritonitis

The correct answer is: Choledocholithiasis and biliary stent

Cholangitis is an infection of the bile duct that typically occurs when there is an obstruction. The common causes of this condition primarily relate to blockages that can lead to stasis of bile and subsequent infection. The presence of choledocholithiasis, or gallstones in the common bile duct, is a well-recognized cause of cholangitis. These stones can impede the normal flow of bile and create an environment conducive to bacterial growth. When the bile duct is obstructed, the bile is retained, leading to inflammation and infection, hallmark characteristics of cholangitis. Additionally, the presence of a biliary stent can also be a contributing factor. While biliary stents are often placed to relieve obstructions, they can predispose to bacterial colonization and infection of the bile ducts. This is particularly true if the stent is not properly functioning or if there is a resultant stasis due to its position or blockage. Understanding these mechanisms highlights why correct identification of these causes is critical in managing cholangitis effectively. It emphasizes the importance of addressing both the underlying obstruction and any infectious complications that result from it.