Obligatory medical device diagnostics. Endoscopic retrograde cholangiopancreatography (ERCP) – Diagnostic method in gastroenterology that combines endoscopy and radiology. It involves radiographic imaging of the biliary system and pancreatic duct as part of an endoscopic examination. Tissue biopsies (tissue samples) and bile aspirates (aspirate = body material obtained by aspiration) can also be obtained. For the … Bacterial Cholangitis: Diagnostic Tests
Surgical therapy depends on the cause of the bile outflow obstruction: For cholelithiasis (gallstones): the surgical procedure of choice is minimally invasive laparoscopic cholecystectomy (gallbladder removal). This involves operating through small openings – the abdomen no longer needs to be cut open – which allows for a shorter hospital stay, a lower complication rate and … Bacterial Cholangitis: Surgical Therapy
The following measures reduce the risk of recurrence (recurrence of the disease) – secondary prevention: Insertion of plastic endoprostheses – keep the bile ducts open and thus ensure unobstructed outflow of bile. Close monitoring of inflammation and cholestasis parameters – CRP (C-reactive protein), leukocyte count, bilirubin, AP (alkaline phosphatase). If drainage present and increase in … Bacterial Cholangitis: Prevention
The following symptoms and complaints may indicate bacterial cholangitis: Pathognomonic (indicative of disease). Charcot triad II – in 60-70% of cases – simultaneous presence of: Biliary colic (colicky pain in the right upper abdomen) – Colic pain is characterized by a waxing and waning, intermittent, spasmodic (convulsive) course of pain. The patient writhes in pain. … Bacterial Cholangitis: Symptoms, Complaints, Signs
Pathogenesis (disease development) At the forefront of pathogenesis is the obstruction of bile flow. Even partial (partial) obstruction, in the majority of cases caused by a stone in the context of cholelithisais (gallstone disease), favors the colonization of bacteria in the bile ducts. The bacteria originate from the duodenum (small intestine), rarely entering the bile … Bacterial Cholangitis: Causes
If symptoms persist or if fever (>38.5 °C rectally) and/or jaundice (jaundice) occur, hospitalization is required. General Measures Aim for normal weight! Determination of BMI (body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for the underweight. BMI ≥ … Bacterial Cholangitis: Therapy
Medical history (history of illness) represents an important component in the diagnosis of bacterial cholangitis. Family history Does your family have a history of diseases of the biliary tract or gallbladder or liver that are common? Social history. Current medical history/systemic history (somatic and psychological complaints). Have you ever had gallstones? Have you noticed any … Bacterial Cholangitis: Medical History
The bile ducts connect the gallbladder (vesica fellea or biliaris, Latin vesica “bladder” and fellis or bilis “bile”) to the small intestine. Through the bile ducts, bile synthesized (formed) in the liver and concentrated (thickened to about 10% of its initial volume; 30-80 ml of bile) in the gallbladder is directed to the small intestine, … Bacterial Cholangitis: Anatomy-Physiology
Infectious and parasitic diseases (A00-B99). AIDS cholangiopathy – changes in the bile ducts caused by AIDS disease. Echinococcosis – infection with a tapeworm of the genus Echinococcus. Other parasites, such as Ascaris lumbricoides, Fasciola hepatica, and Opisthorchis spp. Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87). Acute cholecystitis (gallbladder inflammation). Acute hepatitis (inflammation … Bacterial Cholangitis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by bacterial cholangitis: Infectious and parasitic diseases (A00-B99). Sepsis (blood poisoning): cholangiosepsis (blood poisoning caused by bacterial cholangitis). Liver, gallbladder, and bile ducts-pancreas (pancreas) (K70-K77; K80-K87). Gallbladder empyema (pus accumulation within the gallbladder due to inflammation). Liver abscesses (encapsulated collection of … Bacterial Cholangitis: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) [due topossible symptoms: jaundice]. Abdomen (abdomen): Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin … Bacterial Cholangitis: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count [frequently leukocytosis (increase in white blood cells: > 10-12,000/μl) possibly with left shift, i.e., shift in granulocytes in favor of younger precursors (e.g., rod-nucleated granulocytes; possibly toxic granulations)] Inflammatory parameters – CRP (C-reactive protein). Cholestasis parameter AP (alkaline phosphatase) and GGT (γ-GT, gamma-GT; gamma-glutamyl … Bacterial Cholangitis: Test and Diagnosis
