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The bile duct is a tube that carries bile to the gallbladder and intestines. Bile is formed in the liver and helps in the digestion of fats. Cholangitis is an infection of the bile duct, usually caused by a bacterial infection, which develops when the bile duct gets blocked with a stone or tumour.

Cholangitis is characterised by sharp, dull or cramp-like pain on the upper middle or right side of the abdomen, below the right shoulder blade, or in the back. Other symptoms include fever and chills, vomiting, nausea, clay-coloured stools, dark urine and jaundice. Symptoms are not necessarily constant, and may come and go.

Cholangitis can be diagnosed by reviewing your medical history and performing a thorough physical examination. Your doctor may order blood tests and different imaging tests, such as ultrasound, endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiogram (PTC) and magnetic resonance cholangiopancreatography (MRCP), to clearly view the bile duct and make a definitive diagnosis.

Treatment includes broad spectrum IV antibiotics and fluids. If the symptoms are severe, your doctor may recommend endoscopic biliary drainage and decompression to remove any blockages. Percutaneous transhepatic biliary drainage (PTBD) is another possible nonsurgical method of biliary drainage. Surgery may be advised if these procedures are unsuccessful in opening up the bile duct.


  • Medical Board of Australia
  • Royal Australasian College of Physicians
  • Gastroenterological Society of Australia
  • American Society for Gastrointestinal Endoscopy
  • American Gastroenterological Association
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