Transcript Cholangitis

Cholangitis
Godwin Tse
LA-TRAP
Spring 2011
Definition
• Acute cholangitis – acute infection and
inflammation of the biliary tree
• Other types
▫ Primary sclerosing cholangitis
▫ Recurrent pyogenic cholangitis
▫ AIDS-related cholangitis
Etiology
• Obstruction of the common bile duct due to
gallstones
• Benign strictures
• Malignant strictures
• Sclerosing cholangitis
• Parasites
Risk factors
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Age > 50 years
Cholelithiasis (formation of gallstones)
Benign strictures
Malignant strictures
Postprocedure injury of bile ducts
History of sclerosing cholangitis
Signs and Symptoms
• Charcot’s Triad
▫ Jaundice, fever, and RUQ pain
• Reynold’s Pentad
▫ Addition of altered mental status, and
hypotension
Tests
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transabdominal ultrasound
Endoscopic ultrasound
CT
Magnetic resonance
cholangiopancreatography(MRCP)
• Endoscopic retrograde
cholangiopancreatography (ERCP)
• Lab tests
▫ abnormal LFTs, elevated CRP, WBC
Treatment
• Broad spectrum antibiotics
• Biliary drainage
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ERCP
Percutaneous transhepatic cholangiography (PTC)
EUS guided drainage
Open surgical drainage
References
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http://www.rush.edu/rumc/page-1098987323769.html
http://emedicine.medscape.com/article/774245-overview
http://www.ncbi.nlm.nih.gov/books/NBK6921/
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001335/
https://online.epocrates.com/u/2921345/Ascending+cholangitis/B
asics/Definition
• Molsler P. 2011. Diagnosis and Management of Acute Cholangitis.
Curr Gastroenterol Rep.13:166–172
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