Why ascending cholangitis

Acute cholangitis View PDF external link opens in a new window. Last reviewed: 14 Oct Last updated: 19 Feb Most patients have fever, jaundice, and right upper quadrant pain Charcot triad. The most common causes are choledocholithiasis and benign and malignant strictures. Other diagnostic factors pale stools pruritus hypotension mental status changes Other diagnostic factors. Investigations to consider abdominal CT scan with intravenous contrast magnetic resonance cholangiopancreatography MRCP endoscopic ultrasonography EUS percutaneous trans-hepatic cholangiography PTC surgical approaches More investigations to consider.

Douglas G. Acknowledgements Dr Douglas G. Last reviewed: 14 Oct Last updated: 29 Sep Other diagnostic factors pale stools pruritus hypotension mental status changes Full details. Douglas G. David J. Differentials Acute cholecystitis Peptic ulcer disease Acute pancreatitis More differentials. TG18 management bundles for acute cholangitis and cholecystitis external link opens in a new window TG18 initial management of acute biliary infection and flowchart for acute cholangitis external link opens in a new window More guidelines.

If definitive surgery for an obstructing tumour is required, this is usually deferred until the acute cholangitis has been managed and the patient has stabilised e. In most patients, when adequate biliary drainage is achieved, there is usually marked clinical improvement.

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Anatomical Planes. Anatomy Flashcard Collection. The Inguinal Canal. A man with penile swelling. A man with blood in his urine. PSA Question Bank. Medical Student Finals Question Bank. ABG Quiz. Reading Acute Cholangitis. Share Tweet. Cholangitis is an infection of an obstructed biliary system, most commonly due to common bile duct stones.

Bacteria reach the biliary system either by ascent from the intestine or by the portal venous system. Once the biliary system is colonized, biliary stasis allows bacterial multiplication, and increased biliary pressures enable the bacteria to penetrate cellular barriers and enter the bloodstream.

Patients with cholangitis are febrile, often have abdominal pain, and are jaundiced.