Ascending cholangitis
From Ganfyd
Ascending cholangitis is usually an infective cholangitis resulting in 'ascent' of enteric bacteria up the biliary tree. It is often characterised by Charcot's triad (which with features 4 and 5 forms Reynolds pentad):
- Fever
- Jaundice
- Right upper quandrant abdominal pain
- Altered mental status
- Shock
Treatment
- Identify underlying cause, e.g. gallstone disease.
- Aggressive supportive treatment for sepsis and sepsis-related organ dysfunction.
- Antibiotics, preferably after blood cultures. Ideally a broad spectrum antibiotic that concentrates in the bile[1], e.g. piperacillin/tazobactam (Tazocin®) and has activity against enteric Gram negative organisms such as E. coli and Klebsiella spp.
References
- ↑ Footnote: Some degree of cholestasis is common in this condition, which means that excretion of the antibiotic into bile observed in healthy volunteers may be only a theoretical advantage.
