Acute Cholangitis Differential Diagnoses
- Author: Timothy M Scott, DO; Chief Editor: Barry E Brenner, MD, PhD, FACEP more...
Because pregnant women are prone to symptomatic gallstones, consider cholangitis in pregnant, febrile, or jaundiced patients. Differentiate cholangitis from HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) of preeclampsia, which also can cause abdominal pain and elevated LFTs. Blood pressure is elevated in preeclampsia and may be hypotensive in cholangitis.
Cholelithiasis and cholangitis are uncommon in children, except in those with underlying hemolytic disorders or biliary anomalies.
The incidence of cholangitis is higher in elderly persons, most likely due to the increased prevalence of common bile duct stones with age. As in other infections and abdominal processes, elderly patients frequently do not manifest pathology in a classic pattern. Consider cholangitis in febrile or hypotensive elderly patients.
Other conditions to be considered
Other conditions to consider in patients with suspected acute cholangitis include the following:
Perforated peptic ulcer
Right colon diverticulitis
Cholecystitis and Biliary Colic
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