Cholangitis physical examination: Difference between revisions
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==== Signs of Acute suppurative cholangitis ==== | |||
* [[Fever]] > 39° C | |||
* Sustained [[hypotension]] | |||
* Mental [[confusion]] | |||
* Steady [[abdominal pain]] | |||
=== Charcot's triad === | |||
* [[Fever]] | |||
* [[Abdominal pain]] | |||
* [[Jaundice]] | |||
=== Reynold's pentad === | |||
* [[Fever]] | |||
* [[Abdominal pain]] | |||
* [[Jaundice]] | |||
* [[Confusion]] | |||
* [[Sepsis]] ([[hypotension]]) | |||
===Vitals=== | ===Vitals=== | ||
*Fever | *[[Fever]] | ||
*Septic shock | *[[Septic shock]] | ||
*Elderly patients may present with [[hypotension]]<ref name="book312">{{Citation | *Elderly patients may present with [[hypotension]]<ref name="book312">{{Citation | ||
| last1 = Brunicardi | | last1 = Brunicardi | ||
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| year = 2005 | | year = 2005 | ||
}}</ref> | }}</ref> | ||
===Skin=== | ===Skin=== | ||
*Jaundice | *[[Jaundice]] | ||
===Abdomen=== | ===Abdomen=== | ||
*Right upper quadrant (RUQ) [[tenderness]] | *Right upper quadrant (RUQ) [[tenderness]] | ||
*[[Rebound tenderness]] | *[[Rebound tenderness]] | ||
*[[Abdominal guarding]] may be present | |||
*Abdominal pain<ref name="pmid17556149">{{cite journal |vauthors=Kinney TP |title=Management of ascending cholangitis |journal=Gastrointest. Endosc. Clin. N. Am. |volume=17 |issue=2 |pages=289–306, vi |year=2007 |pmid=17556149 |doi=10.1016/j.giec.2007.03.006 |url=}}</ref> | *Abdominal pain<ref name="pmid17556149">{{cite journal |vauthors=Kinney TP |title=Management of ascending cholangitis |journal=Gastrointest. Endosc. Clin. N. Am. |volume=17 |issue=2 |pages=289–306, vi |year=2007 |pmid=17556149 |doi=10.1016/j.giec.2007.03.006 |url=}}</ref> | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
*Mental confusion | *Mental [[confusion]] | ||
*[[Altered mental status]] | |||
==References== | ==References== | ||
Revision as of 16:31, 23 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Charcot's triad, which includes abdominal pain, jaundice, and fever is a set of three common findings in cholangitis. Reynold's pentad adds to this list two other symptoms, septic shock and mental confusion, which are also common markers in a physical examination for cholangitis. Cholangitis is associated with significant morbidity and mortality.
Physical Examination
Charcot's triad is the classical presentation of acute cholangitis. Only 50-70% of patients exhibit all three features. Fever, which is present in over 90% of patients, is most common. Abdominal pain and clinical jaundice occur in about 80% of patients. Obtaining a complete and accurate patient history is the most important aspect of making a diagnosis of cholangitis. It provides insight into causes, precipitating factors, and associated comorbid conditions.[1]
Signs of Acute suppurative cholangitis
- Fever > 39° C
- Sustained hypotension
- Mental confusion
- Steady abdominal pain
Charcot's triad
Reynold's pentad
Vitals
- Fever
- Septic shock
- Elderly patients may present with hypotension[2]
Skin
Abdomen
- Right upper quadrant (RUQ) tenderness
- Rebound tenderness
- Abdominal guarding may be present
- Abdominal pain[3]
Neuromuscular
- Mental confusion
- Altered mental status
References
- ↑ Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
- ↑ Brunicardi, FC & Schwartz, SI (2005), Schwartz's Principles of Surgery, New York, New York: McGraw-Hill Scientific, Technical & Medical
- ↑ Kinney TP (2007). "Management of ascending cholangitis". Gastrointest. Endosc. Clin. N. Am. 17 (2): 289–306, vi. doi:10.1016/j.giec.2007.03.006. PMID 17556149.