PURPOSE: The aim of this study is to differentiate the cause of acute cholangitis without biliary obstruction in ultrasonography

MATERIALS & METHODS: A total of 81 patients who had acute cholangitis as identified on clinical setting were retrospectively included in this study. Patients were divided into two groups: patients with biliary obstruction such as stone, tumor, lymph node, stricture and patents without biliary obstuction. First group are exluded in this study. A total of 27 patients (33%) had acute cholangitis withous definite distal biliary obstruction. We analyzed the cause, prognosis, imaging feature with USG image.

RESULTS: The cause of acute cholangitis without biliary obsturction were active C.S. cholangitis in 11 cases cases (40.7%), post operative swelling after gastrojejunostomy, PPPD, choledochojejunostomy (22.2%), Mirizzi syndrome in 1case (3.7%), recent passage of distal CBD stone in 2 cases (7.4%), primary sclerosing cholangitis in 2 cases (7.4%), compression effect by large duodenal diverticulum in 1 case (3.7%), and unknown case in 4 cases (14.8%).

CONCLUSIONS: Acute cholangitis may be associated without distal biliary obstruction. Ultrasonography can provide more precise information about cause of acute cholangitis and help to differentiate