297 patienes with acute obstructive suppurative cholangitis (AOSC) were analyzed. 70 of the cases were senile AOSC

and in 26 cases the- AOSC was intrahe-patic. The clinical manifestations in 123 cases consisted mainly of the Charcot’s syndrome

and the remaining 174 cases had in addition mental confusion or/ and shock. Serious complications consisted of toxic shock

acute renal failure

acute hepatic failure

acute general peritonitis

septicemia and bacterial liver abscess. Various biliary drainages were used in treatment. The mortality of the whole sense was 22.05%. The postmortem examination was performed in 4 and in 3 of them retained intrahatic duct stone were found accompanied by suppurative infection

liver abscess

and septicemia.AOSC is intracholangeal suppurative infection under pressure due to nearly complete obstuction of the biliary tract with serious complications and very high mortality. Urgent early diagnosis is exceedingly important for correct treatment in time. In general acure cholangitis should be looked upon as AOSC and treated in time without waiting for the appearance of mental confusion and shock. Relief of biliarytract obstruction with efficient decompression of the biliary tract above the obstruction are the fundemental therapeutic measures for AOSC In this respect

senile AOSC and intrahepatic AOSC sometimes atypical clinically demands special attention. B-ultrsonography before operation may be of great help in diagnosis. At operation asymmetric hepatomegaly and perihepatitis are suggestive and direct puncture of the hepatic duct may be recommended increase both for diagnosis and drainage. Recommend PTCD as a temporary treatment measure.