Recurrent pyogenic cholangitis,Cholangiohepatitis, is an uncommon disease in the western world Most of these cases are seen in Asian countries.
The etiology is unknown, although some of these patients have biliary parasites.
The disease is characterized by a recurrent syndrome of bacterial cholangitis that occurs in association with intrahepatic pigment stones and intrahepatic biliary obstruction.
-These patients are also at risk of developing biliary cirrhosis and cholangiocarcinoma.
-The left lobe is the most common location of the disease due to the delayed drainage of the left system.
This C.T. image shows a typical case of Recurrent pyogenic cholangitis
There is focal dilatation of the bile ducts in the left lobe with stones.
Below there is another example of recurrent pyogenic cholangitis.There is intrahepatic lithiasis with focal diatation.
A case like this is indistinguishable from focal Caroli disease with secundary stone formation.