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Gastrointestinal - Cholangitis
In this episode, we review acute cholangitis, a life-threatening infection of the biliary tree that occurs in the setting of obstruction—most commonly from choledocholithiasis. We break down the pathophysiology of increased intrabiliary pressure leading to bacterial overgrowth and systemic infection, along with the classic presentation of Charcot triad: fever, jaundice, and right upper quadrant pain. The discussion highlights key laboratory and imaging findings, the urgency of ERCP for biliary decompression, and the role of broad-spectrum IV antibiotics.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) An Z, Braseth AL, Sahar N. Acute Cholangitis: Causes, Diagnosis, and Management. Gastroenterol Clin North Am. 2021 Jun;50(2):403-414. doi: 10.1016/j.gtc.2021.02.005. Epub 2021 Apr 23. PMID: 34024448.
3) Sulzer JK, Ocuin LM. Cholangitis: Causes, Diagnosis, and Management. Surg Clin North Am. 2019 Apr;99(2):175-184. doi: 10.1016/j.suc.2018.11.002. Epub 2019 Feb 10. PMID: 30846028.
4) Smith SE. Management of Acute Cholangitis and Choledocholithiasis. Surg Clin North Am. 2024 Dec;104(6):1175-1189. doi: 10.1016/j.suc.2024.03.007. Epub 2024 Apr 27. PMID: 39448120.
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By Kristopher Maday, PA-C, DFAAPAIn this episode, we review acute cholangitis, a life-threatening infection of the biliary tree that occurs in the setting of obstruction—most commonly from choledocholithiasis. We break down the pathophysiology of increased intrabiliary pressure leading to bacterial overgrowth and systemic infection, along with the classic presentation of Charcot triad: fever, jaundice, and right upper quadrant pain. The discussion highlights key laboratory and imaging findings, the urgency of ERCP for biliary decompression, and the role of broad-spectrum IV antibiotics.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) An Z, Braseth AL, Sahar N. Acute Cholangitis: Causes, Diagnosis, and Management. Gastroenterol Clin North Am. 2021 Jun;50(2):403-414. doi: 10.1016/j.gtc.2021.02.005. Epub 2021 Apr 23. PMID: 34024448.
3) Sulzer JK, Ocuin LM. Cholangitis: Causes, Diagnosis, and Management. Surg Clin North Am. 2019 Apr;99(2):175-184. doi: 10.1016/j.suc.2018.11.002. Epub 2019 Feb 10. PMID: 30846028.
4) Smith SE. Management of Acute Cholangitis and Choledocholithiasis. Surg Clin North Am. 2024 Dec;104(6):1175-1189. doi: 10.1016/j.suc.2024.03.007. Epub 2024 Apr 27. PMID: 39448120.