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Self-Assessment Questions

General Surgery

Answer 2
  1. Cholangitis always results from biliary manipulation or bile contamination from an extrahepatic source. Cholangitis is an infection of the bile and is associated with bactobilia that occurs following instrumentation or biliary obstruction. However, extrahepatic contamination is not necessary for cholangitis to occur. Intrahepatic ductal obstruction from idiopathic, iatrogenic, or malignant sources is a common cause of cholangitis. Bacterial hepatic abscess should be treated with percutaneous drainage and intravenous antibiotics. In patients in whom the abscess is inadequately drained or this approach fails, operative drainage may be required. Hydatid cysts are caused by infection with Echinococcus species, a parasite of sheep and wild foxes. The parasite requires a vector to infect humans. Active hydatid infections require surgical resection. The procedure of choice is pericystectomy; however, partial hepatectomy may be required. The preferred systemic therapeutic agent for hydatid disease is albendazole.

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