Acute Cholangitis: An Update in Management Based on Severity Assessment
Acute cholangitis (AC) is a biliary tract emergency which causes significant morbidity and mortality. The direct cause of death in AC is sepsis that leads to irreversible shock and multiple organ failure. The most common predisposition are bile duct stones and previous invasive manipulation of the b...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Interna Publishing
2020-07-01
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| Series: | The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| Subjects: | |
| Online Access: | https://www.ina-jghe.com/index.php/jghe/article/view/680 |
| _version_ | 1797810551889330176 |
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| author | Robert Christeven Frandy Frandy Andersen Andersen |
| author_facet | Robert Christeven Frandy Frandy Andersen Andersen |
| author_sort | Robert Christeven |
| collection | DOAJ |
| description | Acute cholangitis (AC) is a biliary tract emergency which causes significant morbidity and mortality. The direct cause of death in AC is sepsis that leads to irreversible shock and multiple organ failure. The most common predisposition are bile duct stones and previous invasive manipulation of the biliary tree. Biliary infection and biliary obstruction are the two main factors in pathophysiology of AC. Gram-negative bacteria are isolated frequently from bile and blood culture in cholangitis. The most common cause of biliary obstruction is gallstone.
The Charcot’s triad which commonly has been used to diagnose AC is severely limited and the clinical presentation of the disease has wide spectrum ranging from mild symptoms to severe life-threatening disease. Thus, the use of the most updated Tokyo Guidelines (TG18) is imperative to diagnose the disease and to assess the severity. The TG18 diagnostic criteria is based on the presence of systemic inflammmation, cholestasis, and evidence on imaging studies of biliary tract. The prompt treatment is tailored according to severity assessed by TG18. Initial treatment includes sufficient fluid replacement, hemodynamic control, electrolyte compensation, intravenous antibiotic administration, and intravenous analgesic administration. The definitive treatment which related to the pathophysiology of the disease are biliary drainage and antibiotic administration. |
| first_indexed | 2024-03-13T07:10:35Z |
| format | Article |
| id | doaj.art-2d6c10d30f44449dbc25775445902dd4 |
| institution | Directory Open Access Journal |
| issn | 1411-4801 2302-8181 |
| language | English |
| last_indexed | 2024-03-13T07:10:35Z |
| publishDate | 2020-07-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy |
| spelling | doaj.art-2d6c10d30f44449dbc25775445902dd42023-06-06T04:28:32ZengInterna PublishingThe Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy1411-48012302-81812020-07-0119317017710.24871/1932018170-177646Acute Cholangitis: An Update in Management Based on Severity AssessmentRobert Christeven0Frandy Frandy1Andersen Andersen2Department of Emergency, Pemangkat Regional General Hospital, SambasDepartment of Emergency, St Vincentius Hospital, SingkawangDepartment of Emergency, Kartika Husada Army Hospital, Kubu RayaAcute cholangitis (AC) is a biliary tract emergency which causes significant morbidity and mortality. The direct cause of death in AC is sepsis that leads to irreversible shock and multiple organ failure. The most common predisposition are bile duct stones and previous invasive manipulation of the biliary tree. Biliary infection and biliary obstruction are the two main factors in pathophysiology of AC. Gram-negative bacteria are isolated frequently from bile and blood culture in cholangitis. The most common cause of biliary obstruction is gallstone. The Charcot’s triad which commonly has been used to diagnose AC is severely limited and the clinical presentation of the disease has wide spectrum ranging from mild symptoms to severe life-threatening disease. Thus, the use of the most updated Tokyo Guidelines (TG18) is imperative to diagnose the disease and to assess the severity. The TG18 diagnostic criteria is based on the presence of systemic inflammmation, cholestasis, and evidence on imaging studies of biliary tract. The prompt treatment is tailored according to severity assessed by TG18. Initial treatment includes sufficient fluid replacement, hemodynamic control, electrolyte compensation, intravenous antibiotic administration, and intravenous analgesic administration. The definitive treatment which related to the pathophysiology of the disease are biliary drainage and antibiotic administration.https://www.ina-jghe.com/index.php/jghe/article/view/680acute cholangitistokyo guidelinesbiliary tractbiliary obstructiongallstonecharcot’s triad |
| spellingShingle | Robert Christeven Frandy Frandy Andersen Andersen Acute Cholangitis: An Update in Management Based on Severity Assessment The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy acute cholangitis tokyo guidelines biliary tract biliary obstruction gallstone charcot’s triad |
| title | Acute Cholangitis: An Update in Management Based on Severity Assessment |
| title_full | Acute Cholangitis: An Update in Management Based on Severity Assessment |
| title_fullStr | Acute Cholangitis: An Update in Management Based on Severity Assessment |
| title_full_unstemmed | Acute Cholangitis: An Update in Management Based on Severity Assessment |
| title_short | Acute Cholangitis: An Update in Management Based on Severity Assessment |
| title_sort | acute cholangitis an update in management based on severity assessment |
| topic | acute cholangitis tokyo guidelines biliary tract biliary obstruction gallstone charcot’s triad |
| url | https://www.ina-jghe.com/index.php/jghe/article/view/680 |
| work_keys_str_mv | AT robertchristeven acutecholangitisanupdateinmanagementbasedonseverityassessment AT frandyfrandy acutecholangitisanupdateinmanagementbasedonseverityassessment AT andersenandersen acutecholangitisanupdateinmanagementbasedonseverityassessment |