Cholangitis: Difference between revisions

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	Cholangitis;
	Recurrent pyogenic cholangitis. ; (Image courtesy of RadsWiki)
ICD-10	K83.0
ICD-9	576.1
DiseasesDB	2514
eMedicine	med/2665 emerg/96
MeSH	D002761

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Revision as of 16:22, 27 January 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Historical Perspective

Pathophysiology

Epidemiology & Demographics

Risk Factors

Screening

Causes

Differentiating Cholangitis

Complications & Prognosis

Diagnosis

Treatment

References

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Template:WikiDoc Sources

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 ==Treatment==
 [[Cholangitis medical therapy|Medical therapy]] | [[Cholangitis surgery|Surgical options]] | [[Cholangitis primary prevention|Primary prevention]]  | [[Cholangitis secondary prevention|Secondary prevention]] | [[Cholangitis cost-effectiveness of therapy|Financial costs]] | [[Cholangitis future or investigational therapies|Future therapies]]
-== Treatment ==
-% of patients with acute cholangitis will respond to conservative therapy and elective drainage.  In 15-20%, the cholangitis will progress requiring emergent drainage.  Markers for these people are persistent abdominal pain, hypotensive, fever >102, and confusion.
-Patients should be kept [[Nil per os|NPO]], given [[IVF]], broad spectrum ABX, [[Vitamin K]] and be drained.  Choices for drainage are [[ERCP]] with stone removal and [[sphincterotomy]]/[[stent]] placement, surgically drainage or percutaneous drainage. Intra[[hepatic]] stones cannot be removed via ERCP and should be drained [[percutaneously]].  [[Clinical trial#Design|Randomized trial]]s comparing ERCP and [[surgery]] showed [[morbidity]] and [[mortality]] benefit for ERCP (4.7-10% versus 10-50%).  A nasobiliary catheter can be placed if ERCP is impossible (<5%) either because of [[coagulopathy]] precluding sphincterotomy, too large a stone (>2cm) etc.  Next step should be percutaneous drainage as a bridge to elective surgery since emergent surgery has an up to 40% mortality.
 == References ==