UW acute cholangitis Flashcards
Charcot triad in what disease?
Acute cholangitis (AC)
Reynolds pentad in what disease?
Acute cholangitis (AC)
Charcot triad?
fever+jaundice+RUQ pain
Reynolds pentad?
fever+jaundice+RUQ pain (charcot triad)
+/- hypotension + altered mental status
most common cause of acute cholangitis?
calculous obstruction of the common bile duct (ie, choledocholithiasis)
What is choledocholithiasis?
calculous obstruction of the common bile duct
Lab results in acute cholangitis?
Leukocytosis;
cholestatic liver function test:
incr. Alkaline phosphatase
incr. direct bilirubin (hyperbilirubinemia)
+/- transaminases
Causes of acute cholangitis?
ASCENDING INFECTION DUE TO BILIARY !!! EXTRAHEPATIC!!! OBSTRUCTION:
obstructive gallstone, malignancy (cholangiocarcinoma, pancreatic head cancer), stricture (primary sclerosing cholangitis), biliary stent blockage
Sequence of events in acute cholangitis?
extrahepatic biliary obstruction –> incr. pressure in intrahepatic ducts –> injury/fibrosis and bile stasis.
Stucked stone in duct enables what?
enables bacteria to proliferate within the biliary tree (–> ascending cholangitis)
what bacteria in acute cholangitis?
E. coli, klebsiela, enterococus
treatment of acute cholangitis?
ab and intravenous fluid
acute cholangitis imaging?
Abdominal imaging (eg, ultrasound) demonstrates common bile duct dilation, possibly with evidence of an obstructing stone.
