Cholangitis history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
50-60% of patients will have all three of Charcot’s triad. 95% will have fever, 66% abdominal pain, jaundice is noted in 80% (When bilirubin >2.5). Nonobstructive stones are more likely to present without pain or fever. Elderly patients may present only with hypotension. Dark urine is noted and acholia can be seen.
History and Symptoms
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.
The following symptoms may occur:
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
- Clay-colored stools
- Dark urine
- Nausea and vomiting
- Yellowing of the skin (jaundice) -- may come and go