Abstract
Acute cholangitis leading to sepsis is a common occurrence, especially in populations with a highprevalence of gallstones. Unfortunately, the mortality rate related to this issue is high. Recently,we had a case involving an elderly woman who initially had mild acute cholangitis, but it progressedinto a severe case. Respiratory and hematological issues developed, along with worsening septicparameters and liver functions. As a result, she was intubated, ventilated, and monitored in theintensive care unit (ICU). Urgent ERCP failed, but PTBD and percutaneous cholecystostomy wereinserted to aid in biliary decompression and sepsis control. Currently, she is recovering fromsepsis and plans for early ERCP and cholangiogram before definitive surgical intervention. Tohandle obstructed biliary sepsis, early biliary drainage is crucial for urgent biliary decompressionand sepsis control, alongside fluid resuscitation, intravenous antibiotics, and intensive care.
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