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Cholangitis, Acute

Juan Gomez Reviewed 06/2021
 


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 20...

TREATMENT

  • Treatment includes a combination of antibiotic therapy, relief of biliary obstruction and correction of underlying etiology.

  • Empiric antibiotic therapy should be started once the diagnosis is...

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. 

DIET

NPO...

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

Sokal A, Sauvanet A, Fantin B, et al. Acute cholangitis: diagnosis and management. J Visc Surg. 2019Dec;156(6):515-525.  

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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