Cholangitis: Charcot and Reynolds Triads
Acute cholangitis is bacterial infection of the bile ducts on a background of obstruction. It often accompanies common bile duct stones and is an emergency requiring rapid decompression.
Charcot triad
- Fever and chills
- Jaundice
- Right-upper-quadrant pain
Reynolds pentad (severe form)
When shock and altered mental status are added to the Charcot triad, this is called Reynolds pentad and requires emergency intervention.
Diagnosis
Leukocytosis, raised CRP and cholestatic liver enzymes; ultrasound and MRCP visualise the bile ducts.
Treatment
- Broad-spectrum antibiotics
- IV access and supportive care
- Emergency ERCP for biliary decompression
- Planned gallbladder surgery after stabilisation
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