Cholangitis Flashcards
What is acute cholangitis?
Acute cholangitis, also known as ascending cholangitis, is an infection of the biliary tree caused by biliary outflow obstruction and subsequent infection.
What are common symptoms of acute cholangitis?
Fever, right upper quadrant (RUQ) pain, jaundice, pruritus, pale stools, dark urine, nausea, and vomiting.
What is Charcot’s triad?
The combination of fever, right upper quadrant pain, and jaundice, indicative of acute cholangitis.
What is Reynold’s pentad?
Charcot’s triad plus hypotension and confusion, indicating severe acute cholangitis.
What are common causes of biliary obstruction leading to cholangitis?
Gallstones, tumours, biliary strictures, sclerosing cholangitis, and parasitic infections.
Which bacteria are commonly associated with acute cholangitis?
Escherichia coli, Klebsiella species, and Enterococcus species.
What is the initial imaging modality for suspected cholangitis?
Abdominal ultrasound to detect gallstones and bile duct dilation.
What blood tests are typically elevated in acute cholangitis?
Raised white cell count (WCC), C-reactive protein (CRP), bilirubin, alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT).
What is the gold standard diagnostic and therapeutic procedure for cholangitis?
Endoscopic retrograde cholangiopancreatography (ERCP).
What is the first-line treatment for acute cholangitis?
Supportive care with intravenous fluids, broad-spectrum antibiotics, and biliary decompression via ERCP.
What are potential complications of untreated acute cholangitis?
Sepsis, hepatic abscess, acute pancreatitis, and multi-organ failure.
What is the role of percutaneous transhepatic cholangiography (PTC) in cholangitis?
PTC is an alternative method for biliary drainage if ERCP is unsuccessful or contraindicated.
What is the typical age range for the presentation of acute cholangitis?
Median age of presentation is 50-60 years old.
What is the mortality rate associated with acute cholangitis?
Mortality rate ranges between 17-40%.
What is the significance of a dilated common bile duct (CBD) on imaging?
It suggests biliary obstruction, which may lead to cholangitis.
What is the function of the sphincter of Oddi?
It controls the flow of bile and pancreatic juice into the duodenum and prevents reflux of duodenal contents.
What is the anatomical location of the gallbladder?
The gallbladder is located in the right hypochondrium beneath the liver.
What is the primary function of the gallbladder?
To store and concentrate bile produced by the liver.
What is the common bile duct (CBD)?
The duct formed by the union of the common hepatic duct and the cystic duct, which transports bile from the liver and gallbladder to the duodenum.
What is the ampulla of Vater?
The dilated junction where the common bile duct and the pancreatic duct meet before emptying into the duodenum.
What is the hepatocystic triangle?
An anatomical area bordered by the cystic duct, common hepatic duct, and the inferior edge of the liver, important in surgical procedures like cholecystectomy.
What is the role of cholecystokinin in digestion?
It stimulates gallbladder contraction and relaxation of the sphincter of Oddi, facilitating bile release into the duodenum.
What is biliary sludge?
A mixture of particulate matter and mucus that forms in bile, often a precursor to gallstones and can contribute to biliary obstruction.
What is the significance of a positive Murphy’s sign?
It indicates gallbladder inflammation, commonly seen in acute cholecystitis.
