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Ascending Cholangitis

Dr Swapnil Pawar September 16, 2021 40


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    Ascending Cholangitis
    Dr Swapnil Pawar

Ascending Cholangitis

Cholelithiasis: Presence of gallstones within the gallbladder

Choledocholithiasis: Presence of gallstones within the bile ducts

Cholecystitis: Inflammation of the gallbladder

Cholangitis: Inflammation of the bile duct system

Clinical Signs of Ascending Cholangitis

Charcot’s Triad

  • Fever
  • Jaundice
  • Right Upper Quadrant Abdominal Pain

Reynold’s Pentad

  • The 3 Symptoms of Charcot’s Triad
  • Hypotension
  • Confusion

Causes of Biliary Obstruction

Intraluminal:

  • Choledocholithiasis
  • Biliary Strictures (Post-Infectious, autoimmune, congenital)
  • Malignancy (i.e. cholangiocarcinoma)

Extraluminal:

  • Malignancy (pancreatic or duodenal carcinoma)
  • Pancreatitis (from oedema from surrounding pancreatic tissue)
  • Mirizzi Syndrome (Obstruction of the biliary tree through gallstone impacted in the cystic duct) 
  • Lemmel Syndrome (Obstruction of the biliary tree through duodenal diverticula)

Risk Factors for Biliary Stone Formation

Fair – more common in Caucasian patients

Fat  – patients who are obese (BMI >30) or hyperlipidaemia

Female 

Fertile – for women who have had one or more children

Forty – Age > 40

 

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