There are 2% chances of developing cholangitis post ERCP. It is mostly caused by infection by bacteria. The common organisms involve E. coli (20-25%), Klebsiella (10-15%) or enterbacter (5-10%). The infection by parasites like liver flukes can also cause cholangitis. The disease is managed by removing the blockage. It can be done by ERCP and stenting. Antibiotic (meropenem and tazocin are commonly used) and anti-parasitic cover may also be required. Shock is managed by hydration and vital support.