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Sepsis may even progress to involve the liver (Fig. 10), either by contiguity or by ascending biliary infection [10, 11, 22].
In 26 of them, a biliary infection was evidenced by the presence of an Enterobacter-positive bile culture, whereas the remaining 16 patients had no detectable biliary infection.
The presence of biliary infection was excluded by negative bile bacterial culture and normal C-reactive protein (CRP) levels.
In patients with no apparent biliary infection, prohepcidin levels were below 70 ng/ml (median value 8.9), whereas significantly higher levels were seen in patients with acute cholangitis (up to 240 ng/ml; median value 22.3, p = 0.03; Fig. 6A).
Moreover, in PSC patient with cholangitis, prohepcidin levels correlated with CRP (r = 0.48, p = 0.03) and bilirubin serum levels (r = 0.71, p = 0.0002, Fig. 6B,C) thereby suggesting that prohepcidin levels in the bile reflect the extent of biliary infection.
However, the procedure still carries the risk of biliary infection by ascending gastrointestinal bacteria.
Similar(49)
Very rarely postoperative infections after LA may give rise to single or multifocal pyogenic liver abscesses indistinguishable from those caused by intestinal and biliary infections.
Further studies are warranted to analyze the potential of hepcidin as a biliary stress marker as well as to more directly evaluate its contribution to the defence against biliary infections.
While the role of hepcidin in biliary system is unknown, a recent study demonstrated that conditional gp130-knockout mice display diminished hepcidin levels and increased rate of biliary infections.
Forty-six episodes (28%) were intra-abdominal infections: 36 (22%) surgical site infections, and 10 (6%) biliary infections.
The pathogenesis is unclear, but it often is associated with chronic recurrent biliary infections.
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