Acute Cholangitis Questions & Answers

Updated: Dec 29, 2017
  • Author: Timothy M Scott, DO; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Questions & Answers

Overview

What is acute cholangitis?

What is the spectrum of cholangitis?

What is the pathogenesis of acute cholangitis?

What is the role of bile in the pathophysiology of acute cholangitis?

What is the primary sclerosing cholangitis?

What is the most common cause of acute cholangitis in developed countries?

What causes acute cholangitis?

What is the role of common bile duct (CBD) stones in the etiology of acute cholangitis?

What is the role of obstructive tumors in the etiology of acute cholangitis?

What are less common causes of acute cholangitis?

What is the prevalence of acute cholangitis in the US?

What is recurrent pyogenic cholangitis?

What are the racial predilection of acute cholangitis?

How does the prevalence of acute cholangitis vary by sex?

How does the prevalence of acute cholangitis vary by age?

Which factors affect the prognosis of acute cholangitis?

What are the mortality rates for acute cholangitis?

What is the prognosis of acute cholangitis?

Which factors are used to predict mortality risk for acute cholangitis?

What is the role of leukocytosis and bilirubin in determining the prognosis of acute cholangitis?

What causes the high mortality rate of acute cholangitis?

Which patients are at highest risk for mortality from acute cholangitis?

Which factors increase the emergent operative mortality risk of acute cholangitis?

What is the mortality rate of elective surgery for acute cholangitis?

How does the mortality rate for suppurative cholangitis differ from that of acute cholangitis?

What are possible complications of acute cholangitis?

What are the catheter-related complications of acute cholangitis?

Presentation

What are the signs and symptoms of acute cholangitis?

Which medical history increases the risk for acute cholangitis?

What are Charcot’s triad and Reynolds pentad in acute cholangitis?

Which clinical history findings suggest acute cholangitis?

What is a common physical presentation of acute cholangitis?

Which physical findings suggest acute cholangitis?

DDX

When should acute cholangitis be considered in pregnant women?

When should acute cholangitis be considered in children?

When should acute cholangitis be considered in elderly persons?

Which conditions should be included in the differential diagnoses of acute cholangitis?

What are the differential diagnoses for Acute Cholangitis?

Workup

What is the role of procalcitonin measurement in the workup of acute cholangitis?

What is the role of imaging studies in the workup of acute cholangitis?

What is the role of lab studies in the workup of acute cholangitis?

What is the role of ultrasonography in the workup of acute cholangitis?

What are the advantages and disadvantages of ultrasonography for the evaluation of acute cholangitis?

What is the role of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis and management of acute cholangitis?

What is the role of CT scanning in the workup of acute cholangitis?

What are the advantages of CT scanning in the diagnosis of acute cholangitis?

What are the disadvantages of CT scanning for the diagnosis of acute cholangitis?

What is the role of magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of acute cholangitis?

What is the risk of magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of acute cholangitis during pregnancy?

What is the role of radiography in the workup of acute cholangitis?

What is the role of nuclear imaging scans in the workup of acute cholangitis?

What is the role of emergency department (ED) physicians in the treatment of acute cholangitis?

When is ERCP indicated in the treatment of acute cholangitis?

What how is acute cholangitis treated in unstable patients?

Treatment

What is included in prehospital care for patients with suspected acute cholangitis?

What is the prehospital care for unstable patients with acute cholangitis?

When should acute cholangitis be considered in patients presenting in the emergency department (ED)?

What is the focus of emergency department (ED) care for acute cholangitis?

How is acute cholangitis managed in the emergency department (ED)?

What is the response rate to medical treatment for acute cholangitis?

How is acute cholangitis treated in severely ill patients?

What is the role of endoscopic sphincterotomy in the treatment of acute cholangitis?

What is included in emergency department (ED) medical therapy for acute cholangitis?

What is endoscopic nasobiliary drainage (ENBD) for the treatment of acute cholangitis?

What is the initial medical care for acute cholangitis in the ICU?

What is the duration of antibiotic therapy for acute cholangitis?

What is the efficacy of switching from IV to oral antibiotics in the treatment of acute cholangitis?

When is transfer considered for the treatment of acute cholangitis?

What is required for minimum initial stabilization for transport of patients with acute cholangitis?

Which specialist consultations are needed for the management of acute cholangitis?

Which specialists should be consulted prior to performing emergent procedures for the treatment of acute cholangitis?

How can mortality rates for acute cholangitis be reduced?

What are the treatment options for unstable septic patients with acute cholangitis?

How is acute cholangitis prevented?

Medications

What is the goal of antimicrobial therapy in the treatment of acute cholangitis?

How are antibiotics administered for the treatment of acute cholangitis?

Which combinations of antibiotics are effective in the treatment of acute cholangitis?

What are the medication options for the treatment of acute cholangitis?

Which medications in the drug class Antibiotics are used in the treatment of Acute Cholangitis?