Cholangitis differential diagnosis: Difference between revisions

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Chronic
Chronic
! rowspan="2" |Disease
! rowspan="2" |Disease
! colspan="5" |Clinical findings
! colspan="7" |Clinical findings
! rowspan="2" |Causes
! rowspan="2" |Causes
! colspan="2" |Laboratory findings
! colspan="2" |Laboratory findings
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|-
!Fever
!Fever
!Rigors and chills
!Abdominal  
!Abdominal  
pain and its site
pain  
!Site of pain
!Jaundice
!Jaundice
!Hypotension
!Hypotension
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'''Ascending cholangits'''
'''Ascending cholangits'''
| +
| +
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* +
|<nowiki>+</nowiki>
* RUQ
|RUQ
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| +
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* [[Nausea and vomiting]]
* [[Nausea and vomiting]]
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'''cholangitis'''
'''cholangitis'''
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| ++
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| +
* +
|<nowiki>+</nowiki>
* RUQ
|RUQ
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| +
| +
| +
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|'''[[Acute cholecystitis]]'''
|'''[[Acute cholecystitis]]'''
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|
* +
| +
* RUQ
|RUQ
|−
|−
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|'''[[Acute pancreatitis]]'''
|'''[[Acute pancreatitis]]'''
|
|
* +
| +
* LUQ, radiating to back
|LUQ, radiating to back
|−
|−
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|'''[[Acute appendicitis]]'''
|'''[[Acute appendicitis]]'''
|
| + in pyogenic  type
* +
| +
* Starts in Umblical area and radiates to LLQ
|Starts in Umblical area and radiates to LLQ
|−
|−
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|'''[[Acute hepatitis]]'''
|'''[[Acute hepatitis]]'''
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| +
|−
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|'''[[Diverticulitis|Acute diverticulitis]]'''
|'''[[Diverticulitis|Acute diverticulitis]]'''
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| +
|−
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|−
|−
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|'''[[Peptic ulcer|Peptic Ulcer]]'''
|'''[[Peptic ulcer|Peptic Ulcer]]'''
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|−
|−
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|'''[[Liver abscess]]'''
|'''[[Liver abscess]]'''
| ++
| ++
|
| +
* +
| +
* RUQ
|RUQ
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|
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|[[Choledocholithiasis|'''Choledocholithiasis''']]
|[[Choledocholithiasis|'''Choledocholithiasis''']]
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| -
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|'''[[Primary sclerosing cholangitis|Primary sclerosing]]'''  
|'''[[Primary sclerosing cholangitis|Primary sclerosing]]'''  
'''[[Primary sclerosing cholangitis|cholangitis]]'''
'''[[Primary sclerosing cholangitis|cholangitis]]'''
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|'''Primary biliary sclerosis'''
|'''Primary biliary sclerosis'''
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|-
|'''[[Chronic pancreatitis]]'''
|'''[[Chronic pancreatitis]]'''
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|-
|'''[[Hepatitis]]'''
|'''[[Hepatitis]]'''
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|'''Liver [[Cirrhosis]]'''
|'''Liver [[Cirrhosis]]'''
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| colspan="11" |RUQ= Right upper quadrant of the abdomen, LUQ= Left Upper quadrant, LLQ = Left lower quadrant  
| colspan="13" |RUQ= Right upper quadrant of the abdomen, LUQ= Left Upper quadrant, LLQ = Left lower quadrant  
|}
|}



Revision as of 19:50, 23 October 2017

Cholangitis Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

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Differentiating Cholangitis from other Diseases

Epidemiology and Demographics

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

Overview

Cholangitis must be differentiated from other causes of infection in the common bile duct, as well as inflammation and infection of cholecystitis.

Differentiating Cholangitis from other Diseases

Cholangitis should be differentiated from the following:[1]

Acute/

Chronic

Disease Clinical findings Causes Laboratory findings Treatment
Fever Rigors and chills Abdominal

pain

Site of pain Jaundice Hypotension Other findings
Acute Acute cholangitis /

Ascending cholangits

+ + RUQ +
  • Gall stones
Acute suppurative

cholangitis

++ + + RUQ + +
  • Gall stones
Acute cholecystitis ± + RUQ ±
  • Gall stones
Acute pancreatitis ± + LUQ, radiating to back ±
  • Gall stones
Acute appendicitis ± + in pyogenic type + Starts in Umblical area and radiates to LLQ ±
Acute hepatitis + +
Acute diverticulitis +
Peptic Ulcer ±
Liver abscess ++ + + RUQ ±
Choledocholithiasis -
Chronic Primary sclerosing

cholangitis

Primary biliary sclerosis
Chronic pancreatitis
Hepatitis
Liver Cirrhosis
RUQ= Right upper quadrant of the abdomen, LUQ= Left Upper quadrant, LLQ = Left lower quadrant

References

  1. Miura F, Takada T, Kawarada Y, Nimura Y, Wada K, Hirota M, Nagino M, Tsuyuguchi T, Mayumi T, Yoshida M, Strasberg SM, Pitt HA, Belghiti J, de Santibanes E, Gadacz TR, Gouma DJ, Fan ST, Chen MF, Padbury RT, Bornman PC, Kim SW, Liau KH, Belli G, Dervenis C (2007). "Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 27–34. doi:10.1007/s00534-006-1153-x. PMC 2784508. PMID 17252294.


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