Cholangitis historical perspective
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2], Farwa Haideri [3]
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Overview
Dr. Jean-Martin Charcot, a French physician, is credited with discovering cholangitis in the late 19th century. He referred to the condition as "hepatic fever." Charcot's triad of fever, jaundice, and right upper quadrant abdominal pain is the classical presentation of cholangitis. By adding septic shock and mental status changes to the list of symptoms, Dr. B. M. Reynolds and Dr. Everett L. Dargan changed Charcot's triad to Reynold's pentad. Until 1968, the mainstay of treatment of cholangitis was surgery, with the exploration of the bile duct and excision of gallstones, until the advent of endoscopic retrograde cholangiopancreatography (ERCP).
Historical Perspective
- In 1877, at the Salpêtrière Hospital in Paris, France, Dr. Jean-Martin Charcot was first credited with describing cholangitis.[1]
- He initially referred to this condition as a triad of three symptoms: abdominal pain, fever, and jaundice.
- In 1959, American surgeon Dr. Benedict M. Reynolds ignited interest in the condition with his report with colleague Dr. Everett L. Dargan.[2]
- The report discussed how the condition was generally treated by surgeons, as an exploration of the bile duct and excision of gallstones.
- Reynolds and Dargan recognized that septic shock and mental status changes portended a poor outcome.[3][4][5][6]
- The addition of these two symptoms gave rise to the Reynold's pentad, which is commonly used in clinical practice nowadays.
- In 1968, endoscopic retrograde cholangiopancreatography (ERCP) was first used for the diagnosis and management of acute cholangitis.
- In modern times, seventy to eighty percent of cases of acute cholangitis are resolved by antibiotics; some cases may require ERCP to achieve surgical decompression.[1][7]
References
- ↑ 1.0 1.1 Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR (2007). "Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 15–26. doi:10.1007/s00534-006-1152-y. PMC 2784509. PMID 17252293.
- ↑ REYNOLDS BM, DARGAN EL (1959). "Acute obstructive cholangitis; a distinct clinical syndrome". Ann. Surg. 150 (2): 299–303. PMC 1613362. PMID 13670595.
- ↑ Kadakia S. Biliary Tract Emergencies. Med Clin North Amer. 1993, 77(5) 1015-1036. PMID 8371614
- ↑ Carpenter H. Bacterial and Parasitic Cholangitis. May Clin Proc. 1998, 73:473-478. PMID 9581592
- ↑ Leese T, Neoptolemos JP, Baker AR. Management of acute cholangitis and the impact of endoscopic sphincterotomy. Br J Surg. 1986, 73:988. PMID 3790964
- ↑ Lai ECS, Mok FPT, Tan ESY. Endoscopic biliary drainage for severe acute cholangitis. NEJM 1992, 326:1582-6. PMID 1584258
- ↑ Hui CK, Lai KC, Yuen MF, Ng M, Lai CL, Lam SK (2001). "Acute cholangitis--predictive factors for emergency ERCP". Aliment. Pharmacol. Ther. 15 (10): 1633–7. PMID 11564004.