ascending cholangitis

Question 1

what is ascending cholangitis?

Answer 1

1. biliary tract obstruction
2. bile stasis
3. bacterial infection of bile
4. infection ascends the billiary tract and may reach liver

Question 2

what are the risk factors?

Answer 2

1. cholecystitis

2. iatrogenic - stent/ERCP

Question 3

Name 3 clinical features?

Answer 3

‘Charcot’s triad’

1. abdominal pain
2. high fever
3. jaundice

Question 4

What is ‘Reynold’s pentad’

Answer 4

1. charcot cholangitis triad
   +
2. hypotension
3. mental status change

Question 5

What are the results of lab tests?

Answer 5

1. leukocytosis

2. high CRP

Question 6

Imaging

Answer 6

1. RUQ Ultrasound

2. ERCP if high clinical suspicion

Question 7

Tx

Answer 7

1. ERCP is both diagnostic and theraputic
2. Immediate mx
   - IV Abx -
   - IV fluid
   - Oxygen
   - Analgesia