Cholangitis other diagnostic studies: Difference between revisions

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VisualWikitext

Revision as of 20:25, 15 April 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Blood tests to check levels of liver enzymes are the first step in diagnosing cholangitis. Doctors can confirm the diagnosis using cholangiography, which provides pictures of the bile ducts.

Other Diagnostic Studies

Blood Tests

A routine blood test can show:^[1]

Features of acute inflammation (raised white blood cell count and elevated C-reactive protein levels)
Abnormal liver function tests (LFTs).
- LFTs will be consistent with the following obstructions:
  - Raised bilirubin
  - Increased alkaline phosphate levels
  - Increased γ-glutamyl transpeptidase.
- In early stages, pressure on the liver cells could be the main result on LFTs, so they might resemble those in hepatitis, with elevations in alanine transaminase and [[aspartate transaminase00.

Blood cultures are often performed in people with fever and evidence of acute infection. These yield the bacteria causing the infection in 36% of cases, usually after 24–48 hours of incubation. Bile, too, may be sent for culture during endoscopic retrograde cholangiopancreatography (ERCP). The most common types of bacteria linked to cholangitis are gram-positve and gram-negative.^[1]

Gram-negative includes:
- - Escherichia coli (25–50%)
  - Klebsiella (15–20%)
  - Enterobacter (5–10%).
Of the gram-positive strains, Enterococcus causes 10–20% of cases.

References

↑ ^1.0 ^1.1 Cholangitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Ascending_cholangitis#Diagnosis Accessed on April 15, 2016

Template:WikiDoc Sources

[efg123-1] 1.0 ^1.1 Cholangitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Ascending_cholangitis#Diagnosis Accessed on April 15, 2016

[1]

@@ Line 2: / Line 2: @@
 {{Cholangitis}}
 {{CMG}}
+==Overview==
+[[Blood tests]] to check levels of liver enzymes are the first step in diagnosing cholangitis. Doctors can confirm the diagnosis using [[cholangiography]], which provides pictures of the [[bile ducts]].
 ==Other Diagnostic Studies==
+===Blood Tests===
+A routine blood test can show:<ref name="efg123"> Cholangitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Ascending_cholangitis#Diagnosis Accessed on April 15, 2016</ref>
+*Features of acute inflammation (raised [[white blood cell]] count and elevated C-reactive protein levels)
+*Abnormal [[liver function tests]] (LFTs).
+**LFTs will be consistent with the following obstructions:
+***Raised [[bilirubin]]
+***Increased [[alkaline phosphate]] levels
+***Increased [[γ-glutamyl transpeptidase]].
+**In early stages, pressure on the liver cells could be the main result on LFTs, so they might resemble those in [[hepatitis]], with elevations in [[alanine transaminase]] and [[aspartate transaminase00.
-* [[Endoscopic retrograde cholangiopancreatography]] ([[ERCP]]): ERCP uses an endoscope—a long, flexible, lighted tube—that goes down the mouth, beyond the stomach, and into the duodenum to reach an area in the digestive tract where dye can be injected into the bile ducts. X rays are taken when the dye is injected. ERCP also can be used to take a tissue sample or to treat blocked ducts.
+Blood cultures are often performed in people with [[fever]] and evidence of acute infection. These yield the bacteria causing the infection in 36% of cases, usually after 24–48 hours of incubation. [[Bile]], too, may be sent for culture during [[endoscopic retrograde cholangiopancreatography]] (ERCP). The most common types of bacteria linked to cholangitis are gram-positve and gram-negative.<ref name="efg123"> Cholangitis. Wikipedia (2016). https://en.wikipedia.org/wiki/Ascending_cholangitis#Diagnosis Accessed on April 15, 2016</ref>
-* [[Magnetic resonance cholangiopancreatography]] ([[MRCP]]): MRCP uses magnetic resonance imaging (MRI) to obtain pictures of the bile ducts. MRI machines use radio waves and magnets to scan internal organs and tissues. MRCP does not involve using x rays or inserting instruments into the body. This safe and painless test is increasingly used for diagnosis.
+*Gram-negative includes:
-* Percutaneous transhepatic cholangiogram ([[PTCA]]): This procedure involves inserting a needle through the skin and placing a thin tube into a duct in the liver. Dye is injected through the tube and x rays are taken.
+***[[Escherichia coli]] (25–50%)
+***[[Klebsiella]] (15–20%)
+***[[Enterobacter]] (5–10%).
+*Of the gram-positive strains, [[Enterococcus]] causes 10–20% of cases.
 ==References==