Cholangitis differential diagnosis: Difference between revisions
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|'''Acute cholangitis /''' | |'''Acute cholangitis /''' | ||
'''Ascending cholangits''' | '''Ascending cholangits''' | ||
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* [[Nausea and vomiting]] | |||
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|[[Intestinal perforation|'''Intestinal perforation''']] | |||
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|[[Choledocholithiasis|'''Choledocholithiasis''']] | |[[Choledocholithiasis|'''Choledocholithiasis''']] | ||
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|[[RUQ]] | |[[RUQ]] | ||
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|[[Nephrolithiasis or Kidney stones|'''Nephrolithiasis or Kidney stones''']] | |||
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|'''Liver [[Cirrhosis]]''' | |'''[[Liver]] [[Cirrhosis]]''' | ||
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Revision as of 15:28, 26 October 2017
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Cholangitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Cholangitis differential diagnosis On the Web |
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American Roentgen Ray Society Images of Cholangitis differential diagnosis |
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Risk calculators and risk factors for Cholangitis differential diagnosis |
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
Cholangitis must be differentiated from other causes of infection in the common bile duct, as well as inflammation and infection of cholecystitis.and mainly from other causes of acute abdomen.
Differentiating Cholangitis from other Diseases
Cholangitis should be differentiated from the following:[1]
- Acute cholecystitis
- Acute hepatitis
- Acute pancreatitis
- Biliary stricture
- Cancer of the common bile duct
- Cholestatic liver disease
- Cirrhosis
- Duodenal ulcer
- Gastic ulcer
- Pancreatic cancer
Differentiating acute cholangitis from other causes of acute abdomen
| Acute/
Chronic |
Disease | Clinical findings | Causes | Laboratory findings | Treatment | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fever | Rigors and chills | Abdominal pain | Site of pain | Jaundice | Hypotension | Other findings | ||||||
| Acute | Acute cholangitis /
Ascending cholangits |
+ | − | + | RUQ | + | − |
|
||||
| Acute suppurative
cholangitis |
++ | + | + | RUQ | + | + |
|
|||||
| Acute cholecystitis | ± | − | + | RUQ | ± | − |
|
|||||
| Acute pancreatitis | ± | − | + | LUQ, radiating to back | ± | − |
|
|||||
| Acute appendicitis | ± | + in pyogenic/
perforated type |
+ | Starts in umblical area and radiates to LLQ | − | + in perforated appendix | ||||||
| Acute hepatitis | + | − | + | RUQ | + | |||||||
| Acute diverticulitis | + | − | + | LLQ | − | |||||||
| Peptic Ulcer | ± | − | + | Epigastrium or
RUQ (in duodenal ulcer) |
− | |||||||
| Intestinal perforation | ± | − | + | Diffuse | − | ± | ||||||
| Liver abscess | ++ | + | + | RUQ | ± | |||||||
| Choledocholithiasis | ± | − | ± | RUQ | + | |||||||
| Nephrolithiasis or Kidney stones | ||||||||||||
| Ruptured ovarian cyst / Ovarian torsion | ± | − | + | LLQ/ RLQ | − | |||||||
| Tubo-ovarian abscess | + | + | + | LLQ/ RLQ | − | |||||||
| Chronic | Primary sclerosing | |||||||||||
| Primary biliary sclerosis | ||||||||||||
| Chronic pancreatitis | ||||||||||||
| Hepatitis | ||||||||||||
| Liver Cirrhosis | ||||||||||||
| RUQ= Right upper quadrant of the abdomen, LUQ= Left Upper quadrant, LLQ = Left lower quadrant, RLQ= Right lower quadrant | ||||||||||||
References
- ↑ Miura F, Takada T, Kawarada Y, Nimura Y, Wada K, Hirota M, Nagino M, Tsuyuguchi T, Mayumi T, Yoshida M, Strasberg SM, Pitt HA, Belghiti J, de Santibanes E, Gadacz TR, Gouma DJ, Fan ST, Chen MF, Padbury RT, Bornman PC, Kim SW, Liau KH, Belli G, Dervenis C (2007). "Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines". J Hepatobiliary Pancreat Surg. 14 (1): 27–34. doi:10.1007/s00534-006-1153-x. PMC 2784508. PMID 17252294.