Cholangitis other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
[[Blood tests]] to check levels of liver enzymes are the first step in diagnosing cholangitis. Doctors can confirm the diagnosis using | [[Blood tests]] to check levels of liver enzymes are the first step in diagnosing cholangitis. Doctors can confirm the diagnosis using a cholangiography, which provides pictures of the [[bile ducts]]. | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
Revision as of 20:11, 20 September 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]
Overview
Blood tests to check levels of liver enzymes are the first step in diagnosing cholangitis. Doctors can confirm the diagnosis using a 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 transaminase.
- LFTs will be consistent with the following obstructions:
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-positive and gram-negative.[2]
- Gram-negative includes:
- Escherichia coli (25–50%)
- Klebsiella (15–20%)
- Enterobacter (5–10%)
- Of the gram-positive strains, 10–20% of cases are caused by Enterococcus.