Ascending Cholangitis Flashcards
1
Q
Charcot’s triad
A
RUQ pain
Jaundice
Fever
2
Q
Presentation
A
RUQ pain - biliary colic
Fever
Jaundice
Pruritis
Pale stools
3
Q
Reynold’s Pentad
A
Charcot’s triad + hypotension + confusion
- indicative of severe ascending supportive cholangitis
4
Q
Investigations
A
Abdominal examination Obs Bloods - FBC, U+Es, LFTs, CRP Abdo USS ERCP - gold standard MRCP
5
Q
Management
A
Analgesia
IV abx - broad spectrum until future returns - Tazocin
Maintenance fluids
Non operative - ERCP +/- sphincterotomy + drainage stent
Operative - cholecystectomy
6
Q
When to operate or biliary decompression via ERCP
A
If symptoms persist despite abx and intensive management
Within 24 - 48 hrs after admission
7
Q
If unfit for ERCP
A
Percutaneous trans - hepatic cholangiography
8
Q
Pathophysiology
A
Inflammation and infection of the biliary tract can be due to stone in common biliary duct
9
Q
Complications
A
Acute pancreatitis
Inadequate drainage
10
Q
Typical causative organism
A
E. Coli
