(Infection)

Overview

• AKA Ascending Cholangitis
• Bacterial infection (usually E.coli) ****of biliary tract → usually secondary to biliary obstruction and stasis (choledocholithiasis)
• Occurs in up to 9% of patients with Cholelithiasis (gallstones in gallbladder)
• M=F, 50-60 yrs old
• Causes → Choledocholithiasis (gallstones in common bile duct), Biliary Strictures (narrowing of bile duct - can occur after ERCP or due to cancer)

Making Diagnosis

Clinical Features:

• Charcot's Triad → RUQ Pain, Fever, Jaundice (Obstructive secondary to biliary obstruction)
  • May also have pale stool and dark urine
• Reynolds Pentad includes hypotension and mental status changes → can occur due to septic shock

More severe systemic upset than cholecystitis and may cause jaundice

Investigations:

• Ultrasound Scan → first-line in suspected cases to look for common bile duct dilation and bile duct stones
• Increased WBC & CRP