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Cholangitis

Cholangitis. Godwin Tse LA-TRAP Spring 2011. Definition.  Acute cholangitis – acute infection and inflammation of the biliary tree Other types Primary sclerosing cholangitis Recurrent pyogenic cholangitis AIDS-related cholangitis. Etiology.

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Cholangitis

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  1. Cholangitis Godwin Tse LA-TRAP Spring 2011

  2. Definition •  Acute cholangitis – acute infection and inflammation of the biliary tree • Other types • Primary sclerosing cholangitis • Recurrent pyogenic cholangitis • AIDS-related cholangitis

  3. Etiology • Obstruction of the common bile duct due to gallstones • Benign strictures • Malignant strictures • Sclerosing cholangitis • Parasites

  4. Risk factors • Age > 50 years • Cholelithiasis (formation of gallstones) • Benign strictures • Malignant strictures • Postprocedure injury of bile ducts • History of sclerosing cholangitis

  5. Signs and Symptoms • Charcot’s Triad • Jaundice, fever, and RUQ pain • Reynold’s Pentad • Addition of altered mental status, and hypotension

  6. Tests • transabdominal ultrasound • Endoscopic ultrasound • CT • Magnetic resonance cholangiopancreatography(MRCP) • Endoscopic retrograde cholangiopancreatography (ERCP) • Lab tests • abnormal LFTs, elevated CRP, WBC

  7. Treatment • Broad spectrum antibiotics • Biliary drainage • ERCP • Percutaneous transhepatic cholangiography (PTC) • EUS guided drainage • Open surgical drainage

  8. References • http://www.rush.edu/rumc/page-1098987323769.html • http://emedicine.medscape.com/article/774245-overview • http://www.ncbi.nlm.nih.gov/books/NBK6921/ • http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001335/ • https://online.epocrates.com/u/2921345/Ascending+cholangitis/Basics/Definition • Molsler P. 2011. Diagnosis and Management of Acute Cholangitis. Curr Gastroenterol Rep.13:166–172

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