Cholangitis history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
The classical clinical manifestation of Cholangitis is described by Charcot's triad and includes fever, right upper quadrant pain, and jaundice. In suppurative cholangitis hypotension, and confusion can occur. The pentad of presentation is then called as Reynold's pentad. Reynold's pentad is associated with significant morbidity, and mortality.
History and Symptoms
The three classical presentation of Charcot’s triad are present only in 50-60% of the patient population. 95% patients may have fever, 66% abdominal pain, and jaundice is noted in 80% (with a bilirubin >2.5). Nonobstructive stones are more likely to present without pain or fever. Elderly patients may present only with hypotension.
Charcot's Triad
Abdominal Pain
- Right or middle of the upper abdomen
- Intermittent
- Sharp, crampy, or dull
- Radiation to back or below the right shoulder blade
Fever
- With chills and rigor
Jaundice
Reynold's Pentad
- In suppurative cholangitis hypotension, and confusion can occur along with Charcot's triad. The pentad of presentation is then called as Reynold's pentad.
- Reynold's pentad is associated with significant morbidity, and mortality.