Cholangitis history and symptoms: Difference between revisions
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{{CMG}}; {{AE}} {{FH}} | |||
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{{Cholangitis}} | {{Cholangitis}} | ||
==Overview== | ==Overview== | ||
Obtaining a thorough and accurate history is the most important | Obtaining a thorough and accurate history is the most important part of making a [[diagnosis]] of cholangitis. A positive history of [[gallstones]] and [[common bile duct]] stones, recent [[cholecystectomy]], [[endoscopic]] manipulation or [[endoscopic retrograde cholangiopancreatography]] (ERCP), [[cholangiogram]] and history of [[HIV]] or [[AIDS]] all point towards a diagnosis of cholangitis in the presence of [[Charcot's triad]]. [[Symptoms]] of cholangitis include [[fever]], [[abdominal pain]], [[nausea and vomiting]], [[Jaundice|jaundice/yellowish discoloration of skin]], [[acholic stools]]/pale stools, [[pruritus]], [[malaise]], and [[confusion]]. | ||
== History and Symptoms == | |||
*A positive history of [[gallstones]] and [[common bile duct]] stones, recent [[cholecystectomy]], endoscopic manipulation via [[endoscopic retrograde cholangiopancreatography]] ([[Endoscopic retrograde cholangiopancreatography|ERCP]]), [[cholangiogram]] and history of [[HIV]] or [[AIDS]] | |||
==History== | *[[Symptoms]] of cholangitis include [[fever]], [[abdominal pain]], [[nausea and vomiting]], [[Jaundice|jaundice/yellowish discoloration of skin]], [[acholic stools]]/pale stools, [[pruritus]], [[malaise]], and [[confusion]]. | ||
A complete history | ===History=== | ||
A complete history may help determine the appropriate therapy and [[prognosis]]. A positive history of the following is suggestive of cholangitis in the presence of positive [[Symptoms and Signs|signs and symptoms]]:<ref name="book123">{{Citation | |||
| last1 = Afdhal | | last1 = Afdhal | ||
| first1 = NH | | first1 = NH | ||
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| edition = 24 | | edition = 24 | ||
| year = 2011 | | year = 2011 | ||
}}</ref> | }}</ref><ref name="pmid21207254">{{cite journal |vauthors=Mosler P |title=Diagnosis and management of acute cholangitis |journal=Curr Gastroenterol Rep |volume=13 |issue=2 |pages=166–72 |year=2011 |pmid=21207254 |doi=10.1007/s11894-010-0171-7 |url=}}</ref> | ||
*[[Gallstones]] and [[common bile duct]] stones | *[[Gallstones]] and [[common bile duct]] stones | ||
*Recent [[cholecystectomy]] | *Recent [[cholecystectomy]] | ||
*Endoscopic manipulation or [[endoscopic retrograde cholangiopancreatography]] (ERCP) | *[[Endoscopic]] manipulation of the biliary tree or [[endoscopic retrograde cholangiopancreatography]] ([[Endoscopic retrograde cholangiopancreatography|ERCP]]) | ||
**[[Cholangiogram]] | **[[Cholangiogram]] | ||
*History of [[HIV]] or [[AIDS]] | *History of [[HIV]] or [[AIDS]] | ||
**AIDS-related cholangitis is characterized by extrahepatic biliary [[edema]], [[ulceration]], and obstruction. | **[[AIDS]]-related cholangitis is characterized by extrahepatic biliary [[edema]], [[ulceration]], and obstruction. | ||
== | ===Common symptoms=== | ||
{| align="right" | |||
|[[File:Cholangitis Jaundice.jpg|thumb|250px|Sclerotic jaundice in a female patient with ascending cholangitis, Maracay, Venezuela.<ref>By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793</ref>]] | |||
|} | |||
Common [[symptoms]] of cholangitis include: <ref name="book123">{{Citation | |||
| last1 = Afdhal | | last1 = Afdhal | ||
| first1 = NH | | first1 = NH | ||
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| edition = 24 | | edition = 24 | ||
| year = 2011 | | year = 2011 | ||
}}</ref><ref name="book12">{{Citation | }}</ref><ref name="pmid21207254" /><ref name="book12">{{Citation | ||
| last1 = Liu | | last1 = Liu | ||
| first1 = Chi-Leung. | | first1 = Chi-Leung. | ||
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| place = Munich, Germany | | place = Munich, Germany | ||
| year = 2001 | | year = 2001 | ||
}}</ref> | }}</ref><ref name="pmid19652653">{{cite journal |vauthors=Lee JG |title=Diagnosis and management of acute cholangitis |journal=Nat Rev Gastroenterol Hepatol |volume=6 |issue=9 |pages=533–41 |year=2009 |pmid=19652653 |doi=10.1038/nrgastro.2009.126 |url=}}</ref> | ||
* | *[[Abdominal pain]] in the [[right upper quadrant]] | ||
**May be felt in the back or below the right [[shoulder blade]] | |||
**Episodic | |||
**Sharp, cramp-like, or dull | |||
*[[Fever]], maybe associated with [[Rigors|rigors and chills]] | |||
*[[Jaundice]]/ yellowish discoloration of [[skin]] and [[sclera]] | |||
*[[Nausea and vomiting]] | |||
===Less common symptoms=== | |||
Less common [[symptoms]] of cholangitis include | |||
*Pale/ [[acholic stools]] | |||
*[[Malaise]] | |||
*[[Confusion]] | *[[Confusion]] | ||
*[[Pruritus]] | *[[Pruritus]] | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
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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
Obtaining a thorough and accurate history is the most important part of making a diagnosis of cholangitis. A positive history of gallstones and common bile duct stones, recent cholecystectomy, endoscopic manipulation or endoscopic retrograde cholangiopancreatography (ERCP), cholangiogram and history of HIV or AIDS all point towards a diagnosis of cholangitis in the presence of Charcot's triad. Symptoms of cholangitis include fever, abdominal pain, nausea and vomiting, jaundice/yellowish discoloration of skin, acholic stools/pale stools, pruritus, malaise, and confusion.
History and Symptoms
- A positive history of gallstones and common bile duct stones, recent cholecystectomy, endoscopic manipulation via endoscopic retrograde cholangiopancreatography (ERCP), cholangiogram and history of HIV or AIDS
- Symptoms of cholangitis include fever, abdominal pain, nausea and vomiting, jaundice/yellowish discoloration of skin, acholic stools/pale stools, pruritus, malaise, and confusion.
History
A complete history may help determine the appropriate therapy and prognosis. A positive history of the following is suggestive of cholangitis in the presence of positive signs and symptoms:[1][2]
- Gallstones and common bile duct stones
- Recent cholecystectomy
- Endoscopic manipulation of the biliary tree or endoscopic retrograde cholangiopancreatography (ERCP)
- History of HIV or AIDS
- AIDS-related cholangitis is characterized by extrahepatic biliary edema, ulceration, and obstruction.
Common symptoms
 |
Common symptoms of cholangitis include: [1][2][4][5]
- Abdominal pain in the right upper quadrant
- May be felt in the back or below the right shoulder blade
- Episodic
- Sharp, cramp-like, or dull
- Fever, maybe associated with rigors and chills
- Jaundice/ yellowish discoloration of skin and sclera
- Nausea and vomiting
Less common symptoms
Less common symptoms of cholangitis include
References
- ↑ 1.0 1.1 Afdhal, NH; Goldman, L & Schafer, Al (2011), Goldman's Cecil Medicine (24 ed.), Philadelphia, PA: Saunders Elsevier
- ↑ 2.0 2.1 Mosler P (2011). "Diagnosis and management of acute cholangitis". Curr Gastroenterol Rep. 13 (2): 166–72. doi:10.1007/s11894-010-0171-7. PMID 21207254.
- ↑ By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793
- ↑ Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
- ↑ Lee JG (2009). "Diagnosis and management of acute cholangitis". Nat Rev Gastroenterol Hepatol. 6 (9): 533–41. doi:10.1038/nrgastro.2009.126. PMID 19652653.