What is the complication following ascending cholangitis that involves pus accumulation in the liver?

• A. Hemorrhagic cyst
• B. Pyogenic liver abscess
• C. Hematoma
• D. Gallbladder perforation

Answer: (B)

The complication following ascending cholangitis that involves pus accumulation in the liver is a pyogenic liver abscess. Ascending cholangitis is an infection of the bile duct system, often related to obstruction, such as from gallstones. The infection can lead to the migration of bacteria into the liver parenchyma, resulting in the formation of an abscess filled with pus, characteristic of a pyogenic process.

When the bile ducts are obstructed and infected, the local host response may be inadequate, allowing bacteria to invade the liver tissue. This can lead to localized infection, manifesting as a pyogenic liver abscess, which is typically characterized by fever, abdominal pain, and sometimes jaundice. Imaging studies such as ultrasound or CT scans can help diagnose the presence of these abscesses.

Other options don’t reflect the conditions arising from ascending cholangitis. For example, a hemorrhagic cyst primarily refers to a fluid-filled sac that has bleeding, which is unrelated to bile duct infection. A hematoma refers to a localized collection of blood outside of blood vessels, which is not pertinent in this context. Gallbladder perforation, while a potential complication of gallbladder disease, does not specifically describe the accumulation of pus in