Acute cholangitis

Question 1

Charcot’s triad of (1/3 of patients) (PFJ)
[…] […] […] pain
[…]
[…]

Sepsis features - Hypotension, tachycardia and confusion are also common symptoms if the sepsis is severe

Answer 1

Charcot’s triad of (1/3 of patients):
Right upper quadrant pain
Fever
Jaundice

Question 2

Causes

[…] […] (stones) – 50%
Benign […] […] – 20%. These can be congenital, post-infectious, or inflammatory.
[…] – 10-20%. These can be due to tumour in the gallbladder, bile duct, ampulla, duodenum, pancreas.

Answer 2

Biliary calculi (stones) – 50%
Benign biliary stricture – 20%. These can be congenital, post-infectious, or inflammatory.
Malignancy – 10-20%. These can be due to tumour in the gallbladder, bile duct, ampulla, duodenum, pancreas.

Question 3

Invx
[…] LFTs with raised […] […] (WCCs and CRP
USS -[…][…] […] and bile duct […]

Answer 3

Invx
raised LFTs with raised inflammatory markers (WCCs and CRP
USS - bile duct dilation and bile duct stones

Question 4

Mx
[…] […]
[…] […][…] ([…]) after 24-48 hours to relieve any […]

Answer 4

Mx
intravenous antibiotics
endoscopic retrograde cholangiopancreatography (ERCP) after 24-48 hours to relieve any obstruction