Recurrent pyogenic cholangitis
Recurrent pyogenic cholangitis (a.k.a. cholangiohepatitis) is a condition that most commonly affects patients of East Asian origins. It is characterized by recurrent bouts of cholangitis in association with intrahepatic pigment stones and intrahepatic biliary obstruction.
Pathogenesis
In RPC the gallstones found within the biliary system are calcium bilirubinate stones or pigmented calcium stone. Calcium bilirubinate stones are prevalent in Asia and very rare in Europe and the United States. In addition to the presence of these friable concretions of various shapes and sizes within the biliary tree, the bile is often muddy in consistency and contains numerous fine particles of calcium bilirubinate. This differs greatly from cholesterol stones, which are common in Rurope and the United States, which contain >96% of cholesterol in pure cholesterol stone, and 71.3% in mixted cholesterol stone. The peculiarity of the formation of calcium bilirubinate sontes in RPC has been ascribed to the high incidence of bile being infected with Escherchia coli. In man, the major portion of bilirubin is excreted in bile as bilirubin glucuronide.