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 Laboratory tests that may support diagnosis:Leukocytosis (with neutrophilic predominance).Transaminitis.Hyperbilirubinemia (conjugated).Elevated alkaline phosphatase.Elevated gamma‐glutamyl transferase level.

 Imaging:Ultrasound:Best initial study. Can detect dilation of the common bile duct, gallstones, and other evidence of pathology.CT with IV contrast:Helpful for looking at other potential causes of biliary obstruction.May show complications such as hepatic abscesses.CT findings that may support the diagnosis of cholangitis include dilation of intra‐ or extra‐hepatic biliary ducts, thickening of the ductal walls, presence of gallstones. Magnetic resonance cholangiopancreatography:Sensitive imaging modalityMay not be readily available at all institutions.