# Recurrent Pyogenic Cholangiohepatitis: A Case Report

## TL;DR

This case report describes a patient with recurrent pyogenic cholangitis, a rare bile duct disease, and emphasizes its importance in differential diagnosis.

## Contribution

The paper adds a new clinical case of RPC and emphasizes its recognition in patients with liver abscesses and cholangitis.

## Key findings

- RPC was diagnosed in a Bangladeshi male with chronic hepatitis B and liver abscesses.
- The case highlights the need to consider RPC in patients with recurrent liver abscesses and cholangitis symptoms.
- RPC is characterized by bile duct strictures, dilatation, and pigmented stones.

## Abstract

Recurrent pyogenic cholangitis (RPC), which is most commonly seen in Asian populations, is characterized by strictures and dilatation of both intrahepatic and extrahepatic bile ducts, along with the formation of pigmented stones inside the ducts. The most common symptoms are recurrent right upper quadrant pain, jaundice, and fever. Additionally, leukocytosis and elevated alkaline phosphatase and bilirubin levels may also be present.

We report the case of a 43-year-old Bangladeshi male patient with a medical background of chronic hepatitis B infection and recurrent liver abscesses who presented to the emergency department with abdominal pain and fever lasting for two days.

Given the clinical context of our patient, a diagnosis of RPC was made, and the patient was referred to a higher-level center for further management. Our case highlights the importance of considering RPC as part of the differential diagnosis in patients presenting with recurrent liver abscesses and features of ascending cholangitis.