Cholangitis physical examination

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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, which includes Charcot's triad and two other symptoms, septic shock and mental confusion, are also common markers in a physical examination for cholangitis. It 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.

Vitals

• Fever (with chills and rigor)
• Septic shock
• Elderly patients may present with hypotension

Skin

• Jaundice

Abdomen

• Right upper quadrant (RUQ) tenderness
  • Intermittent
  • Sharp, crampy, or dull
  • Radiation to back or below the right shoulder blade
• Abdominal pain

Neuromuscular

• Mental confusion

References

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