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Cholangitis, Acute

Christina Marie Colosimo, DO, MS and Tommy Manh Tran, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Acute infection and inflammation of the extrahepatic biliary system caused by partial or complete obstruction of the biliary tree, most commonly by gallstones migrating into the comm...

DIAGNOSIS

  • Diagnosis of acute cholangitis is made based on a combination of clinical signs and symptoms, laboratory results and imaging findings.

  • The diagnostic criteria for acute cholangitis in the 201...

TREATMENT

  • Treatment includes a combination of antibiotic therapy, biliary decompression, and management of underlying etiology if possible.

  • Empiric antibiotic therapy should be started as soon as possi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients with recurrent symptoms of cholangitis may require maintenance antibiotics and more advanced imaging to exclude liver abscess or residual stones. 

Patient Monitoring

REFERENCES

1
Weber  A, Schneider  J, Wagenpfeil  S, et al. Spectrum of pathogens in acute cholangitis in patients with and without biliary endoprosthesis. J Infect.  2013;6...

ADDITIONAL READING

  • Lyu Y, Wang B, Ye S, et al. Impact of the timing of endoscopic retrograde cholangiopancreatography for the treatment of acute cholangitis: a meta-analysis and systematic ...

SEE ALSO

Cholelithiasis 

CODES

ICD10

K83.0 Cholangitis 

SNOMED

6215006 Acute cholangitis 

CLINICAL PEARLS

  • Charcot triad (fever, jaundice, and RUQ pain) is seen in 40–70% of cases and has low sensitivity but high specificity for ascending cholangitis.

  • Obstruction due to malignancy (Courvoisi...

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