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Acute cholangitis carries a significant risk of death, the leading cause being irreversible shock with multiple organ failure (a possible complication of severe infections). [7] Improvements in diagnosis and treatment have led to a reduction in mortality: before 1980, the mortality rate was greater than 50%, but after 1980 it was 10–30%. [7]
The differential diagnosis can include primary biliary cholangitis (formerly referred to as primary biliary cirrhosis), drug-induced cholestasis, cholangiocarcinoma, IgG4-related disease, post-liver transplantation nonanastomotic biliary strictures, [23] and HIV-associated cholangiopathy. [24]
Reynolds' pentad is a collection of signs and symptoms consistent with obstructive ascending cholangitis, a serious infection of the biliary tract.It is a combination of Charcot's triad (right upper quadrant pain, jaundice, and fever) with shock (low blood pressure, tachycardia) and an altered mental status. [1]
If the above symptoms coincide with fever and chills, the diagnosis of ascending cholangitis may also be considered. More than 70% of people with gallstones are asymptomatic and are diagnosed incidentally during ultrasound. Studies have shown that 10% of those with gallstones will develop symptoms within 5 years of diagnosis, and 20% within 20 ...
Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune disease of the liver. [ 1 ] [ 2 ] [ 3 ] It results from a slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up in the liver, a condition called cholestasis .
Charcot's cholangitis triad is the combination of jaundice; fever, usually with rigors; and right upper quadrant abdominal pain. It occurs as a result of ascending cholangitis (an infection of the bile duct in the liver). When the presentation also includes low blood pressure and mental status changes, it is known as Reynolds' pentad. [1]
Diagnosis requires elevated serum alkaline phosphatase persisting for at least 6 months and the presence of bile duct strictures on cholangiogram. [ 39 ] [ 40 ] Unlike primary biliary cholangitis , PSC lacks a diagnostic autoantibody or reliable biomarker of disease progression.
Symptoms of recurrent cholangitis, jaundice, right upper quadrant pain, and elevated bilirubin and alkaline phosphatase may or may not be present. Acute presentations of the syndrome include symptoms consistent with cholecystitis. Surgery is extremely difficult as Calot's triangle is often obliterated and the risks of causing injury to the CBD ...
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