Decreased bile acid synthesis

Increased cholesterol synthesis in the

liver
INCREASED RISK IN:
Super saturation of bile with cholesterol
 Presence of Gallstones
 Recent Cholecystectomy
Formation of precipitate  Endoscopic manipulation
Biliary Tract Obstruction  Elderly
 HIV or AIDS
CHOLELITHIASIS
Elevated Intraluminal Pressure

Infection of bile due to E. Coli

LABORATORY
 Positive Blood Culture
 Increased ALP and CRP
 Mildly Increased AST and
ALT
 Decreased Calcium

SYSTEMIC GASTROINTESINAL TRACT CARDIOVASCULAR

 Fever  Right Upper  Tachycardia
 Chills Quadrant Pain  Hypotension
 Rigor  Jaundice
 Malaise  Mild Hepatomegaly