ACUTE CHOLANGITIS Legend says that Cholangitis was first defined in 1877 by Jean-Martin Charcot, at which time the pathognomonic triad of fever, right upper quadrant pain, and jaundice was described. Today, cholangitis is defined as the presence of increased hepatic intraductal pressure with a concurrent infection of the obstructed bile. Chole: Derived from the Greek word “cholē” meaning bile. Angio: Comes from the Greek “angeion” meaning vessel. Cholangitis: Bacterial infection of the biliary tree. The pathogens identified as causative agents of acute ascending cholangitis are gram-negative and anaerobic organisms, the most common including Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, and Citrobacter. Iatrogenic introduction of bacteria commonly occurs post- ERCP in individuals with biliary obstruction. Charcot triad has a high specificity (95.9%), while sensitivity is low (26.4%). Tokyo guidelines (2018) have a sensitivity of 100% and specificity of 87.4%. #cholangitis #biliaryobstruction #Charcottriad #Reynoldpentad
