Cholangitis history and symptoms: Difference between revisions

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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]

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)
- Cholangiogram
History of HIV or AIDS
- AIDS-related cholangitis is characterized by extrahepatic biliary edema, ulceration, and obstruction.

Common symptoms

Sclerotic jaundice in a female patient with ascending cholangitis, Maracay, Venezuela.^[3]

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.

Template:WikiDoc Sources

[book123-1] 1.0 ^1.1 Afdhal, NH; Goldman, L & Schafer, Al (2011), Goldman's Cecil Medicine (24 ed.), Philadelphia, PA: Saunders Elsevier

[pmid21207254-2] 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.

[3] By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793

[book12-4] Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag

[pmid19652653-5] 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.

[1]

[2]

[3]

[4]

[5]

@@ Line 1: / Line 1: @@
 __NOTOC__
-{{CMG}}
+{{CMG}}; {{AE}} {{ADS}} {{FH}}
 {{Cholangitis}}
 ==Overview==
--60% of patients will have all three of Charcot’s triad.  95% will have fever, 66% [[abdominal pain]], jaundice is noted in 80% (When [[bilirubin]] >2.5).  Nonobstructive stones are more likely to present without pain or fever.  Elderly patients may present only with [[hypotension]].  Dark urine is noted and acholia can be seen.
+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==
-The classical clinical manifestation of [[Cholangitis]] is described by [[Charcot's triad]] and includes [[fever]], right upper quadrant pain, and [[jaundice]]. In suppurative cholangitis [[hypotension]], and [[confusion]] can occur. The pentad of presentation is then called as '''[[Reynold's pentad]]'''. Reynold's pentad is associated with significant morbidity, and mortality.
+== 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]]
+*[[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===
+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
+| first1 = NH
+| last2 = Goldman
+| first2 = L
+| last3  = Schafer
+| first3 = Al
+| lastauthoramp = yes
+| title     = Goldman's Cecil Medicine
+| publisher = Saunders Elsevier
+| place     = Philadelphia, PA
+| edition = 24
+| year    = 2011
+}}</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
+*Recent [[cholecystectomy]]
+*[[Endoscopic]] manipulation of the biliary tree or [[endoscopic retrograde cholangiopancreatography]] ([[Endoscopic retrograde cholangiopancreatography|ERCP]])
+**[[Cholangiogram]]
+*History of [[HIV]] or [[AIDS]]
+**[[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
+| first1 = NH
+| last2 = Goldman
+| first2 = L
+| last3  = Schafer
+| first3 = Al
+| lastauthoramp = yes
+| title     = Goldman's Cecil Medicine
+| publisher = Saunders Elsevier
+| place     = Philadelphia, PA
+| edition = 24
+| year    = 2011
+}}</ref><ref name="pmid21207254" /><ref name="book12">{{Citation
+| last1  = Liu
+| first1 = Chi-Leung.
+| last2  = Fan
+| first2 = Sheung-Tat.
+| lastauthoramp = yes
+| title     = Surgical Treatment: Evidence-Based and Problem-Oriented.
+| publisher = Zuckschwerdt Verlag
+| place     = Munich, Germany
+| year    = 2001
+}}</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]]
-'''The following symptoms may occur:'''
+===Less common symptoms===
-===Abdominal pain===
+Less common [[symptoms]] of cholangitis include
-* right or middle of the upper abdomen
+*Pale/ [[acholic stools]]
-* Intermittent
+*[[Malaise]]
-* Sharp, crampy, or dull
+*[[Confusion]]
-* Radiation to back or below the right shoulder blade
+*[[Pruritus]]
-===Fever===
-* With chills and rigor
-===Jaundice===
-* Clay-colored stools
-* Dark urine
-* [[Nausea]] and [[vomiting]]
-* Yellowing of the skin and sclera
 ==References==
 {{Reflist|2}}
-{{WH}}
-{{WS}}
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+[[Category:Emergency medicine]]
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+[[Category:Infectious disease]]
+[[Category:Surgery]]