Acute Cholangitis: Symptoms Plus Management Symptoms: Charcoat’s Triad: Right Upper Quadrant Pain Fever Jaundice Reynolds Pentad: Right Upper Quadrant Pain Fever Jaundice Sepsis (Hypotension) Mental Disturbances Tokyo Criteria A = clinical inflammation Fever CRP raised TLC raised B= Evidence of obstruction By CT or Ultrasound: stone, stricture, CA Pancrease. C= Biochemical evidence: Bilirubin raised ALP raised GGT raised A+B+C= definitive A+C/B+C=Suspected. Management: Conservative Treatment: IV fluids (Ringer lactate/NS) Analgesics(Tramol plus metomide, Ketorolac, Nelbin) Anti-pyretics(Paracetamol) IV antibiotics(Cefrriaxone) If itching: → Anti-histamine. → Questeron sachet (Cholestyramine) → Ursu sachet - Ursodeoxycholic acid Specific Treatment: Biliary drainage by *ERCP *PTBD *Surgical
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