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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).


==Overview==
==Historical Perspective==
Cholangitis was first described as a life-threatening disorder in 1877 by Charcot. In 1955, Reynolds and Dargan recognized that [[septic shock]] and mental status changes portended a poor outcome. (Reynolds’s Pentad). <ref>Kadakia S.  Biliary Tract Emergencies.  Med Clin North Amer. 1993, 77(5) 1015-1036. PMID 8371614</ref> <ref>Carpenter H. Bacterial and Parasitic Cholangitis. May Clin Proc. 1998, 73:473-478. PMID 9581592</ref> <ref>Leese T, Neoptolemos JP, Baker AR.  Management of acute cholangitis and the impact of endoscopic sphincterotomy.  Br J Surg.  1986, 73:988. PMID 3790964</ref> <ref>Lai ECS, Mok FPT, Tan ESY.  Endoscopic biliary drainage for severe acute cholangitis.  NEJM 1992, 326:1582-6. PMID 1584258</ref>
*In 1877, at the Salpêtrière Hospital in Paris, France, Dr. Jean-Martin Charcot was first credited with describing cholangitis.<ref name="pmid17252293">{{cite journal |vauthors=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 |title=Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines |journal=J Hepatobiliary Pancreat Surg |volume=14 |issue=1 |pages=15–26 |year=2007 |pmid=17252293 |pmc=2784509 |doi=10.1007/s00534-006-1152-y |url=}}</ref>
**He initially referred to this condition as a triad of three symptoms[[Abdominal pain, fever and jaundice|: 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.<ref name="pmid13670595">{{cite journal |vauthors=REYNOLDS BM, DARGAN EL |title=Acute obstructive cholangitis; a distinct clinical syndrome |journal=Ann. Surg. |volume=150 |issue=2 |pages=299–303 |year=1959 |pmid=13670595 |pmc=1613362 |doi= |url=}}</ref>
**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 [[Altered mental status|mental status changes]] portended a poor outcome.<ref>Kadakia S.  Biliary Tract Emergencies.  Med Clin North Amer. 1993, 77(5) 1015-1036. PMID 8371614</ref><ref>Carpenter H. Bacterial and Parasitic Cholangitis. May Clin Proc. 1998, 73:473-478. PMID 9581592</ref><ref>Leese T, Neoptolemos JP, Baker AR.  Management of acute cholangitis and the impact of endoscopic sphincterotomy.  Br J Surg.  1986, 73:988. PMID 3790964</ref><ref>Lai ECS, Mok FPT, Tan ESY.  Endoscopic biliary drainage for severe acute cholangitis.  NEJM 1992, 326:1582-6. PMID 1584258</ref>
***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]] ([[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 [[Endoscopic retrograde cholangiopancreatography|ERCP]] to achieve surgical decompression.<ref name="pmid17252293">{{cite journal |vauthors=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 |title=Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines |journal=J Hepatobiliary Pancreat Surg |volume=14 |issue=1 |pages=15–26 |year=2007 |pmid=17252293 |pmc=2784509 |doi=10.1007/s00534-006-1152-y |url=}}</ref><ref name="pmid11564004">{{cite journal |vauthors=Hui CK, Lai KC, Yuen MF, Ng M, Lai CL, Lam SK |title=Acute cholangitis--predictive factors for emergency ERCP |journal=Aliment. Pharmacol. Ther. |volume=15 |issue=10 |pages=1633–7 |year=2001 |pmid=11564004 |doi= |url=}}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 20:55, 29 July 2020


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]
  • In 1959, American surgeon Dr. Benedict M. Reynolds ignited interest in the condition with his report with colleague Dr. Everett L. Dargan.[2]
  • 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. 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.
  2. REYNOLDS BM, DARGAN EL (1959). "Acute obstructive cholangitis; a distinct clinical syndrome". Ann. Surg. 150 (2): 299–303. PMC 1613362. PMID 13670595.
  3. Kadakia S. Biliary Tract Emergencies. Med Clin North Amer. 1993, 77(5) 1015-1036. PMID 8371614
  4. Carpenter H. Bacterial and Parasitic Cholangitis. May Clin Proc. 1998, 73:473-478. PMID 9581592
  5. Leese T, Neoptolemos JP, Baker AR. Management of acute cholangitis and the impact of endoscopic sphincterotomy. Br J Surg. 1986, 73:988. PMID 3790964
  6. Lai ECS, Mok FPT, Tan ESY. Endoscopic biliary drainage for severe acute cholangitis. NEJM 1992, 326:1582-6. PMID 1584258
  7. 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.


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