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Acute Cholangitis




  • Acute cholangitis is a bacterial infection of the biliary tract that results from biliary obstruction. The organisms typically ascend from the duodenum.
  • The most common cause is choledocholithiasis, although neoplasms, postoperative strictures, or other causes of obstruction may be involved.
  • Acute cholangitis is characterized by Charcot’s triad of jaundice, right upper quadrant abdominal pain, and fever.
  • Acute suppurative cholangitis occurs with the presence of pus in the biliary ducts and may result in Reynold’s pentad: Charcot’s triad plus hypotension and confusion.
  • If present, the disease can become rapidly fatal. Initial treatment includes antibiotics,
    fluid and electrolyte replacement, and analgesia.
  • ECRP is the optimal procedure for both diagnosis and treatment when the patient is
    stable.
  • Percutaneous transhepatic cholangiography or open surgical decompression may be required.