What causes bile duct obstruction?

The bile duct is the channel in our body that transports bile. If the bile duct is blocked, it will prevent bile from flowing into the duodenum, which will have a direct impact on the overall operation of the body. Biliary duct obstruction is not a minor illness like a cold. If the blockage lasts for a long time, it will affect the digestion of the duodenum. The body will continue to store waste and toxins, which will affect and threaten the overall health of the body. There are several reasons for bile duct obstruction, such as secondary bile duct stones and biliary ascariasis, bile duct infection, large-scale necrosis of liver cells, etc., all of which may lead to bile duct obstruction.

Symptoms of bile duct obstruction caused by:

1. Secondary to bile duct stones and biliary ascariasis: This is a disease with a high mortality rate among surgical acute abdomen, most of which are secondary to bile duct stones and biliary ascariasis. However, lesions such as bile duct stenosis and bile duct tumors may sometimes also cause this disease. The above diseases cause bile duct obstruction, cholestasis, and secondary bacterial infection. Pathogenic bacteria almost always come from the intestine and enter the bile duct retrogradely through the ampulla of Vater or through the choledochojejunostomy. Bacteria can also enter the bile duct through the blood or lymphatic channels. The main pathogens are Escherichia coli, Klebsiella, Streptococcus faecalis and some anaerobic bacteria.

2. Biliary infection occurs on the basis of existing obstructive diseases such as stones: the bile duct mucosa becomes congested and watery, aggravating the obstruction of the bile duct. The bile gradually becomes purulent, the pressure in the bile duct continues to increase, and the bile duct proximal to the obstruction gradually expands. Under the influence of high pressure in the bile duct containing purulent bile, the liver may swell, and inflammatory changes may also occur in the small bile ducts in the liver and the surrounding liver parenchymal cells.

3. Large areas of liver cell necrosis occur: multiple small abscesses may form in the liver. The bile duct may also become infected and become ulcerated, causing pus and bile duct bleeding. Due to the high pressure in the bile duct, the intrahepatic bile duct capillaries rupture, and purulent bile or even bile thrombus enters the blood circulation through the intrahepatic sinusoids, causing bacteremia and sepsis. In a few cases, pulmonary purulent embolism may also occur. In the later stage, a series of pathophysiological changes such as infectious shock, liver and kidney failure or disseminated intravascular coagulation may occur, which is acute obstructive suppurative cholangitis or acute severe cholangitis. Once these pathological changes occur, even if the bile duct hypertension is relieved by surgery, damage will still remain in the liver parenchyma and bile duct, which is why the disease is so serious.