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. Obtaining the history is the most important aspect of making a diagnosis of cholangitis. It provides insight into causes, precipitating factors and associated comorbid conditions.[1]
Vitals
- Fever
- Septic shock
- Elderly patients may present with hypotension[2]
Skin
- Jaundice
Abdomen
- Right upper quadrant (RUQ) tenderness
- Abdominal pain[3]
Neuromuscular
- Mental confusion
References
- ↑ Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
- ↑ Brunicardi, FC & Schwartz, SI (2005), Schwartz's Principles of Surgery, New York, New York: McGraw-Hill Scientific, Technical & Medical
- ↑ Kinney TP (2007). "Management of ascending cholangitis". Gastrointest. Endosc. Clin. N. Am. 17 (2): 289–306, vi. doi:10.1016/j.giec.2007.03.006. PMID 17556149.