Ascending cholangitis history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
Ascending Cholangitis, also known as acute cholangitis is a systemic disease caused by the inflammation and infection of the biliary tree most commonly following an obstruction in the biliary tract. It is characterized by a triad (Charcot's Triad) of fever, jaundice and right upper quadrant pain. A pentad (also known as Reynold's pentad) can also be seen in which altered mental status and sepsis are present in addition to usual findings | Ascending Cholangitis, also known as acute cholangitis is a systemic disease caused by the inflammation and infection of the biliary tree most commonly following an obstruction in the biliary tract. It is characterized by a triad (Charcot's Triad) of [[fever]], [[jaundice]] and [[right upper quadrant pain]]. A pentad (also known as Reynold's pentad) can also be seen in which [[altered mental status]] and [[sepsis]] are present in addition to usual findings | ||
==History and Symptoms== | ==History and Symptoms== | ||
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*Yellowing of the skin (jaundice) - 6- to 70 percent patients | *Yellowing of the skin (jaundice) - 6- to 70 percent patients | ||
*Fever - seen in 90 percent of patients | *Fever - seen in 90 percent of patients | ||
*Chills | *[[Chills]] | ||
*Clay-colored stools | *Clay-colored stools | ||
*Dark urine | *Dark urine | ||
*Nausea and vomiting | *[[Nausea and vomiting|Nausea]] and [[vomiting]] | ||
*Pruritis | *[[Pruritis]] | ||
*Fatigue | *[[Fatigue]] | ||
*The clinical triad of ascending cholangitis are pain, [[jaundice]], and fever ('''[[Charcot's triad]]'''). In addition, the presence of hypotension and mental confusion ('''Reynold's pentad''') is suggestive of severe [[septicemia]]. | *The clinical triad of ascending cholangitis are pain, [[jaundice]], and fever ('''[[Charcot's triad]]'''). In addition, the presence of [[hypotension]] and mental confusion ('''Reynold's pentad''') is suggestive of severe [[septicemia]]. | ||
The typical clinical picture with a triad is present in only 50 to 70 percent of cases<ref name="pmid1098507">{{cite journal| author=Saik RP, Greenburg AG, Farris JM, Peskin GW| title=Spectrum of cholangitis. | journal=Am J Surg | year= 1975 | volume= 130 | issue= 2 | pages= 143-50 | pmid=1098507 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1098507 }}</ref>. | The typical clinical picture with a triad is present in only 50 to 70 percent of cases<ref name="pmid1098507">{{cite journal| author=Saik RP, Greenburg AG, Farris JM, Peskin GW| title=Spectrum of cholangitis. | journal=Am J Surg | year= 1975 | volume= 130 | issue= 2 | pages= 143-50 | pmid=1098507 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1098507 }}</ref>. | ||
=== History === | === History === | ||
Patients with ascending cholangitis may have a positive history of: | Patients with ascending cholangitis may have a positive history of: | ||
* Gallstones | * [[Gallstone disease|Gallstones]] | ||
* Common bile duct stones | * Common bile duct stones | ||
* Cholecystectomy | * [[Cholecystectomy]] | ||
* Cholangiogram | * [[Cholangiogram]] | ||
* ERCP | * [[Endoscopic retrograde cholangiopancreatography|ERCP]] | ||
* Previous history of cholangitis | * Previous history of cholangitis | ||
* HIV or AIDS<ref name="pmid21994858">{{cite journal| author=Gao Y, Chin K, Mishriki YY| title=AIDS Cholangiopathy in an Asymptomatic, Previously Undiagnosed Late-Stage HIV-Positive Patient from Kenya. | journal=Int J Hepatol | year= 2011 | volume= 2011 | issue= | pages= 465895 | pmid=21994858 | doi=10.4061/2011/465895 | pmc=3170813 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21994858 }}</ref> - [[AIDS]]-related cholangitis is characterized by extrahepatic biliary [[edema]], [[ulceration]], and obstruction | * [[Human Immunodeficiency Virus (HIV)|HIV]] or [[HIV AIDS|AIDS]]<ref name="pmid21994858">{{cite journal| author=Gao Y, Chin K, Mishriki YY| title=AIDS Cholangiopathy in an Asymptomatic, Previously Undiagnosed Late-Stage HIV-Positive Patient from Kenya. | journal=Int J Hepatol | year= 2011 | volume= 2011 | issue= | pages= 465895 | pmid=21994858 | doi=10.4061/2011/465895 | pmc=3170813 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21994858 }}</ref> - [[AIDS]]-related cholangitis is characterized by extrahepatic biliary [[edema]], [[ulceration]], and obstruction | ||
==References== | ==References== | ||
Revision as of 18:40, 9 October 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anila Hussain, MD [2]
Overview
Ascending Cholangitis, also known as acute cholangitis is a systemic disease caused by the inflammation and infection of the biliary tree most commonly following an obstruction in the biliary tract. It is characterized by a triad (Charcot's Triad) of fever, jaundice and right upper quadrant pain. A pentad (also known as Reynold's pentad) can also be seen in which altered mental status and sepsis are present in addition to usual findings
History and Symptoms
The following symptoms may occur:
- Abdominal pain which is in the right upper quadrant and is intermittent. Pain is sharp, crampy, or dull and may move to the back or below the right shoulder blade.
- Yellowing of the skin (jaundice) - 6- to 70 percent patients
- Fever - seen in 90 percent of patients
- Chills
- Clay-colored stools
- Dark urine
- Nausea and vomiting
- Pruritis
- Fatigue
- The clinical triad of ascending cholangitis are pain, jaundice, and fever (Charcot's triad). In addition, the presence of hypotension and mental confusion (Reynold's pentad) is suggestive of severe septicemia.
The typical clinical picture with a triad is present in only 50 to 70 percent of cases[1].
History
Patients with ascending cholangitis may have a positive history of:
- Gallstones
- Common bile duct stones
- Cholecystectomy
- Cholangiogram
- ERCP
- Previous history of cholangitis
- HIV or AIDS[2] - AIDS-related cholangitis is characterized by extrahepatic biliary edema, ulceration, and obstruction
References
- ↑ Saik RP, Greenburg AG, Farris JM, Peskin GW (1975). "Spectrum of cholangitis". Am J Surg. 130 (2): 143–50. PMID 1098507.
- ↑ Gao Y, Chin K, Mishriki YY (2011). "AIDS Cholangiopathy in an Asymptomatic, Previously Undiagnosed Late-Stage HIV-Positive Patient from Kenya". Int J Hepatol. 2011: 465895. doi:10.4061/2011/465895. PMC 3170813. PMID 21994858.