ascending cholangitis Flashcards
1
Q
pathology
A
stone stuck somewhere in biliary tree causing blockage to flow from gallbladder but blockage can also block drainage from pancreas and liver - hence the jaundice and raised liver enxymes
2
Q
presentation
A
- severe RUQ pain
- fever
- rigors
- jaundice
charcotts triad - may present septic and/or developed pancreatitis
3
Q
investigation
A
FBC - leukocytosis
LFT - raised ALP + bilirubin
CRP raised
blood cultures
ultrasound - thick wall, GB + bile duct stones + dilated ducts
GS - contrast enhanced dynamic CT
4
Q
management
A
- treat sepsis
- ERCP + stenting - mechanically clear blockage
- surgery / cholecystectomy possible
give fluids
broad-spectrum antibiotics
5
Q
cholecystectomy?
A
remove gallbladder surgery
