Acute cholangitis

Question 1

What is acute cholangitis?

Answer 1

Inflammation of the bile ducts, as a result of infection

Question 2

What are the two most common causes of acute cholangitis?

Answer 2

• Obstruction of the bile ducts, e.g. gallstones

- Infection introduced by ERCP

Question 3

What are the most common causative organisms in acute cholangitis?

Answer 3

• E. coli
• Klebsiella
• Enterococcus

Question 4

What are the typical symptoms/signs in acute cholangitis? What name is used to refer to these symptoms/signs?

Answer 4

Charcot’s triad:

• RUQ pain
• Fever
• Jaundice

Question 5

Acute cholangitis has a high mortality rate. True or false?

Answer 5

True - high mortality rate due to sepsis

Question 6

Describe the initial management of acute cholangitis

Answer 6

• Sepsis six (including IV antibiotics as per local guidelines)
• NBM
• Alert seniors

Question 7

What is the definitive management of acute cholangitis caused by obstruction of the biliary duct?

Answer 7

ERCP