Acute septic cholangitis is an acute septic infection of the bile duct caused by biliary obstruction (most commonly gallstone obstruction), which leads to bile stasis and a rapid increase in bile duct pressure. The infecting organisms are mainly gram-negative bacilli, with Escherichia coli being the most common. The disease has a rapid and dangerous onset and is one of the main causes of death in gallstone patients in China. Symptoms of acute septic cholangitis: In addition to the Charcot triad of acute cholangitis (abdominal pain, chills and high fever, jaundice), there are also manifestations of shock and depression of the central nervous system, called Reynolds’ pentad. The onset is often acute, with sudden onset of severe subxiphoid or right epigastric pain, usually persistent. This is followed by chills and flaccid hyperthermia, and the body temperature may exceed 40°C. It is often accompanied by nausea and vomiting. Most patients have jaundice, but the depth of jaundice is not consistent with the severity of the disease. Nearly half of the patients show signs of central nervous system depression such as agitation, impaired consciousness, lethargy or even coma, and often a drop in blood pressure. This often indicates that septicemia and infectious shock have occurred and is a sign of critical condition. The body temperature is elevated, the pulse rate may increase to more than 120 beats/min, the pulse is weak, and there is significant pressure and muscle tension under the glabella and right upper abdomen. If the gallbladder has not been removed, an enlarged and painful gallbladder and dirty gallbladder can often be found. The white blood cell count is significantly elevated and shifted to the right, up to 20-40,000/mm3, and toxic granules may be present. Serum bilirubin and alkaline phosphatase values are elevated, and there are often signs of hepatic impairment such as increased GPT and r-GT values. Blood cultures often show bacterial growth.