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==Laboratory Findings==
==Laboratory Findings==
===Complete Blood Count===
Laboratory test findings typically associated with cholangitis include:<ref name="book12">{{Citation
* Neutrophilic [[leucocytosis]]<ref name="book12">{{Citation
| last1  = Liu
| last1  = Liu
| first1 = Chi-Leung.  
| first1 = Chi-Leung.  
Line 17: Line 16:
| place    = Munich, Germany  
| place    = Munich, Germany  
| year    = 2001
| year    = 2001
}}</ref>   
}}</ref><ref name="book123">{{Citation
| last1 = Cameron
| first1 = John L.
| last2  = Cameron
| first2 = Andrew M.
| lastauthoramp = yes
| title    = Current Surgical Therapy: Expert Consult
| publisher = Elsevier, Inc. 
| place    = Philadelphia, PA
| year    = 2014
}}</ref> 
*Neutrophilic [[leucocytosis]]
*Cultures should be obtained from [[bile]] aspirated through percutaneous biliary catheters, obtained during biliary drainage, or from indwelling biliary [[prostheses]].
*[[Blood cultures]]
 
===Cholestatic Pattern of Liver Function Tests===
===Cholestatic Pattern of Liver Function Tests===
*[[Blood culture]]<ref name="book12">{{Citation
Cholestatic patterns of liver function tests can indicate:<ref name="book12">{{Citation
| last1  = Liu
| first1 = Chi-Leung.
| last2  = Fan
| first2 = Sheung-Tat.
| lastauthoramp = yes
| title    = Surgical Treatment: Evidence-Based and Problem-Oriented.
| publisher = Zuckschwerdt Verlag
| place    = Munich, Germany
| year    = 2001
}}</ref> 
*Elevated serum [[alkaline phosphatase]]<ref name="pmid22086533">{{cite journal |vauthors=Andraus W, Haddad L, Nacif LS, Silva FD, Blasbalg R, D'Albuquerque LA |title=The best approach for diagnosing primary sclerosing cholangitis |journal=Clinics (Sao Paulo) |volume=66 |issue=11 |pages=1987–9 |year=2011 |pmid=22086533 |pmc=3203975 |doi= |url=}}</ref>
*Elevated [[gammaglutamyl transpeptidase]] (GGT)<ref name="pmid22086533">{{cite journal |vauthors=Andraus W, Haddad L, Nacif LS, Silva FD, Blasbalg R, D'Albuquerque LA |title=The best approach for diagnosing primary sclerosing cholangitis |journal=Clinics (Sao Paulo) |volume=66 |issue=11 |pages=1987–9 |year=2011 |pmid=22086533 |pmc=3203975 |doi= |url=}}</ref>
*Elevated conjugated (direct) [[bilirubin]]<ref name="pmid22086533">{{cite journal |vauthors=Andraus W, Haddad L, Nacif LS, Silva FD, Blasbalg R, D'Albuquerque LA |title=The best approach for diagnosing primary sclerosing cholangitis |journal=Clinics (Sao Paulo) |volume=66 |issue=11 |pages=1987–9 |year=2011 |pmid=22086533 |pmc=3203975 |doi= |url=}}</ref>
*Elevated serum [[amylase]].<ref name="book12">{{Citation
| last1  = Liu
| last1  = Liu
| first1 = Chi-Leung.  
| first1 = Chi-Leung.  
Line 43: Line 42:
| place    = Munich, Germany  
| place    = Munich, Germany  
| year    = 2001
| year    = 2001
}}</ref>  
}}</ref><ref name="pmid22086533">{{cite journal |vauthors=Andraus W, Haddad L, Nacif LS, Silva FD, Blasbalg R, D'Albuquerque LA |title=The best approach for diagnosing primary sclerosing cholangitis |journal=Clinics (Sao Paulo) |volume=66 |issue=11 |pages=1987–9 |year=2011 |pmid=22086533 |pmc=3203975 |doi= |url=}}</ref><ref name="pmid11148988">{{cite journal |vauthors=Björnsson ES, Kilander AF, Olsson RG |title=Bile duct bacterial isolates in primary sclerosing cholangitis and certain other forms of cholestasis--a study of bile cultures from ERCP |journal=Hepatogastroenterology |volume=47 |issue=36 |pages=1504–8 |year=2000 |pmid=11148988 |doi= |url=}}</ref> 
*Elevated serum [[alkaline phosphatase]]
*Elevated gammaglutamyl transpeptidase (GGT)
*Elevated conjugated (direct) [[bilirubin]]
*Elevated serum [[amylase]]
**Levels may be as high as 3-4 times of normal, representing [[pancreatitis]].
**Levels may be as high as 3-4 times of normal, representing [[pancreatitis]].
*Culture from bile obtained during [[ERCP]] ([[endoscopic retrograde cholangiopancreatography]])<ref name="pmid11148988">{{cite journal |vauthors=Björnsson ES, Kilander AF, Olsson RG |title=Bile duct bacterial isolates in primary sclerosing cholangitis and certain other forms of cholestasis--a study of bile cultures from ERCP |journal=Hepatogastroenterology |volume=47 |issue=36 |pages=1504–8 |year=2000 |pmid=11148988 |doi= |url=}}</ref>
*Culture from bile obtained during [[ERCP]] ([[endoscopic retrograde cholangiopancreatography]])
*Elevated [[aminotransferases]] (as high as 1000 IU/L) reflecting hepatocytes injury and microabscess formation.<ref name="book12">{{Citation
*Elevated [[aminotransferases]] (as high as 1000 IU/L) reflecting [[hepatocytes]] injury and microabscess formation.
| last1  = Liu
**Liver abscess is indicated in such cases.
| first1 = Chi-Leung.  
*Liver enzyme abnormalities suggestive of [[cholestasis]]<ref name="book123">{{Citation
| last2  = Fan
| last1  = Cameron
| first2 = Sheung-Tat.  
| first1 = John L.  
| last2  = Cameron
| first2 = Andrew M.  
| lastauthoramp = yes
| lastauthoramp = yes
| title    = Surgical Treatment: Evidence-Based and Problem-Oriented.
| title    = Current Surgical Therapy: Expert Consult
| publisher = Zuckschwerdt Verlag
| publisher = Elsevier, Inc. 
| place    = Munich, Germany
| place    = Philadelphia, PA
| year    = 2001
| year    = 2014
}}</ref>  
}}</ref>
**Liver abscess is indicated in such cases.


==References==
==References==

Revision as of 19:47, 29 April 2016

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

Laboratory tests provide useful clues in the diagnosis of cholangitis. Some commonly conducted tests are complete blood count, basic metabolic panel, liver function tests, blood culture, and other body fluid culture.

Laboratory Findings

Laboratory test findings typically associated with cholangitis include:[1][2]

  • Neutrophilic leucocytosis
  • Cultures should be obtained from bile aspirated through percutaneous biliary catheters, obtained during biliary drainage, or from indwelling biliary prostheses.
  • Blood cultures

Cholestatic Pattern of Liver Function Tests

Cholestatic patterns of liver function tests can indicate:[1][3][4]

References

  1. 1.0 1.1 Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
  2. 2.0 2.1 Cameron, John L. & Cameron, Andrew M. (2014), Current Surgical Therapy: Expert Consult, Philadelphia, PA: Elsevier, Inc.
  3. Andraus W, Haddad L, Nacif LS, Silva FD, Blasbalg R, D'Albuquerque LA (2011). "The best approach for diagnosing primary sclerosing cholangitis". Clinics (Sao Paulo). 66 (11): 1987–9. PMC 3203975. PMID 22086533.
  4. Björnsson ES, Kilander AF, Olsson RG (2000). "Bile duct bacterial isolates in primary sclerosing cholangitis and certain other forms of cholestasis--a study of bile cultures from ERCP". Hepatogastroenterology. 47 (36): 1504–8. PMID 11148988.


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