Acute Cholangitis Flashcards
What is acute cholangitis?
Infection and inflammation in the bile ducts
Surgical emergency
What are the two main causes of acute cholangitis?
Gallstones in the common bile duct
Infection due to ERCP
What are the most common causative organisms of acute cholangitis?
Escherichia coli
Klebsiella species
Enterococcus species
How does acute cholangitis present?
Charcot’s triad
- RUQ pain
- Fever
- Jaundice
How is acute cholangitis managed?
Emergency admission
NbM
IV fluids
Blood cultures
IV antibiotics
ICU
ERCP
What imaging can be used to diagnose common bile duct stones and cholangitis?
Endoscopic US
MRCP
CT
Abdominal US
What is an ERCP used for?
Remove stones blocking the bile duct
What procedures can be performed during an ERCP?
Cholangio-pancreatography
Injection of contrast into duct through sphincter of Oddi
Sphincterotomy
Cut in the sphincter to dilate it and allow stone removal
Stone removal
Balloon dilatation
Inserted and inflated to treat strictures
Biliary stenting
Stent inserted to maintain a patent bile duct
Biopsy
What is a percutaneous transhepatic cholangiogram for?
Relieves the immediate obstruction
Option if ERCP is unsuitable
Radiologically guided insertion of drain through liver into bile ducts
