Cholangitis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2] Farwa Haideri [3]

Overview

Obtaining a thorough and accurate history is the most important part of making a diagnosis of cholangitis. A positive history of gallstones and common bile duct stones, recent cholecystectomy, endoscopic manipulation or endoscopic retrograde cholangiopancreatography (ERCP), cholangiogram and history of HIV or AIDS all point towards a diagnosis of cholangitis in the presence of Charcot’s triad. Symptoms of cholangitis include fever, abdominal pain, nausea and vomiting, jaundice/yellowish discoloration of skin, acholic stools/pale stools, pruritus, malaise, and confusion.

History and Symptoms

A positive history of gallstones and common bile duct stones, recent cholecystectomy, endoscopic manipulation via endoscopic retrograde cholangiopancreatography (ERCP), cholangiogram and history of HIV or AIDS

Symptoms of cholangitis include fever, abdominal pain, nausea and vomiting, jaundice/yellowish discoloration of skin, acholic stools/pale stools, pruritus, malaise, and confusion.

History

A complete history may help determine the appropriate therapy and prognosis. A positive history of the following is suggestive of cholangitis in the presence of positive signs and symptoms:^[1]^[2]

Gallstones and common bile duct stones
Recent cholecystectomy
Endoscopic manipulation of the biliary tree or endoscopic retrograde cholangiopancreatography (ERCP)
- Cholangiogram
History of HIV or AIDS
- AIDS-related cholangitis is characterized by extrahepatic biliary edema, ulceration, and obstruction.

Common symptoms

Sclerotic jaundice in a female patient with ascending cholangitis, Maracay, Venezuela.^[3]

Common symptoms of cholangitis include: ^[1]^[2]^[4]^[5]

Abdominal pain in the right upper quadrant
- May be felt in the back or below the right shoulder blade
- Episodic
- Sharp, cramp-like, or dull
Fever, maybe associated with rigors and chills
Jaundice/ yellowish discoloration of skin and sclera
Nausea and vomiting

Less common symptoms

Less common symptoms of cholangitis include

References

↑ ^1.0 ^1.1 Afdhal, NH; Goldman, L & Schafer, Al (2011), Goldman’s Cecil Medicine (24 ed.), Philadelphia, PA: Saunders Elsevier
↑ ^2.0 ^2.1 Mosler P (2011). “Diagnosis and management of acute cholangitis”. Curr Gastroenterol Rep. 13 (2): 166–72. doi:10.1007/s11894-010-0171-7. PMID 21207254.
↑ By Bobjgalindo – Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793
↑ Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag
↑ Lee JG (2009). “Diagnosis and management of acute cholangitis”. Nat Rev Gastroenterol Hepatol. 6 (9): 533–41. doi:10.1038/nrgastro.2009.126. PMID 19652653.

Template:WikiDoc Sources

[book123-1] 1.0 ^1.1 Afdhal, NH; Goldman, L & Schafer, Al (2011), Goldman’s Cecil Medicine (24 ed.), Philadelphia, PA: Saunders Elsevier

[pmid21207254-2] 2.0 ^2.1 Mosler P (2011). “Diagnosis and management of acute cholangitis”. Curr Gastroenterol Rep. 13 (2): 166–72. doi:10.1007/s11894-010-0171-7. PMID 21207254.

[3] By Bobjgalindo – Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793

[book12-4] Liu, Chi-Leung. & Fan, Sheung-Tat. (2001), Surgical Treatment: Evidence-Based and Problem-Oriented., Munich, Germany: Zuckschwerdt Verlag

[pmid19652653-5] Lee JG (2009). “Diagnosis and management of acute cholangitis”. Nat Rev Gastroenterol Hepatol. 6 (9): 533–41. doi:10.1038/nrgastro.2009.126. PMID 19652653.

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