Cholangitis

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Cholangitis

(Ascending Cholangitis)

  • bacterial infection of bile ducts

Causes

  • gallstones in common bile duct
  • biliary strictures
  • neoplasms
  • following ERCP

History

  • Charcot's Triad (70% of cases)
    • fever / rigors
    • jaundice
    • upper abdominal pain
  • older patients may present with collapse / Gram-negative septicaemia

Investigations

  • FBC
    • leucocytosis
  • Blood Cultures

Treatment

  • fluids
  • antibiotics
    • ciprofloxacin
    • IV amoxycillin + gentamicin
    • ceftazidime
  • Management of Gallstones
  • ERCP / MRCP if not resolved

Complications

  • severe Gram-negative septicaemia
 

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