# Cholangitis: infection of a blocked bile duct

Source: https://onco.cc/terms/acute-cholangitis/  
OnCo record `acute-cholangitis` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cholangitis is infection in bile that cannot drain past a blockage or a blocked stent; fever or shivering with jaundice or a stent is a same-day emergency because it can turn into sepsis within hours.

## Summary

The Tokyo Guidelines 2018 (Kiriyama et al.) define acute cholangitis by systemic inflammation (fever or raised inflammatory markers) together with evidence of cholestasis (jaundice or abnormal liver tests) and of a biliary blockage on imaging, and grade it by organ dysfunction; treatment is antibiotics and drainage of the blocked duct, urgently in severe cases. In gallbladder and bile duct cancer the blockage is the tumour or a blocked stent, so the NHS bile duct cancer page lists "a high temperature, or you feel hot, cold or shivery" among the symptoms, and Cancer Research UK tells people with a stent to "contact your doctor straight away if you have signs of infection such as a high temperature or shivering".

The NHS sepsis page says to call 999 or go to A&E if an adult "is breathing very fast", "is confused, has slurred speech, or is not making sense", "has blue, pale or blotchy skin", "has a very high or very low temperature, feels hot or cold to the touch, or is shivery", "has a rash that does not fade when you press it" or "has symptoms you're worried might be sepsis", and notes that people having chemotherapy are at higher risk. In practice: a temperature or shaking with a stent in place or with jaundice means ringing the 24-hour oncology line or NHS 111 now, and 999 if any of the sepsis signs are present. This is orientation from public patient pages, not advice for your case: your own team's instructions and 24-hour number come first.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: acute cholangitis; biliary sepsis; stent infection

## Sources

- Kiriyama et al., Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (J Hepatobiliary Pancreat Sci 2018): https://doi.org/10.1002/jhbp.512
- Cancer Research UK: biliary stents: https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/treatment/stents
- NHS: sepsis: https://www.nhs.uk/conditions/sepsis/
- NHS: bile duct cancer, symptoms: https://www.nhs.uk/conditions/bile-duct-cancer/symptoms/

## Connected records

- cancers: [Gallbladder cancer](https://onco.cc/cancers/gallbladder/)
- technologies: [Biliary stenting and drainage](https://onco.cc/technologies/biliary-stenting-drainage/)
- terms: [Biliary stent problems: blockage and infection](https://onco.cc/terms/biliary-stent-problems/), [Carers: what you can do and UK carer support](https://onco.cc/terms/carers-gallbladder-cancer-uk/), [Living with jaundice and itching (biliary cancer)](https://onco.cc/terms/jaundice-and-itch-biliary/), [Obstructive jaundice and biliary obstruction](https://onco.cc/terms/obstructive-jaundice/), [Pain with gallbladder and bile duct cancer](https://onco.cc/terms/pain-with-biliary-cancer/), [When to seek urgent help with gallbladder cancer (NHS 111 and 999)](https://onco.cc/terms/urgent-help-gallbladder-cancer/)

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