Biological and bacteriological at cholangitis
Biology:
FNS (Formula Blood Count)
A small-anemia without any particular characteristic.-A significant rise in white blood cells (WBC)> 15,000 éléments/mm3 in neutrophils (75-90%).
Liver
Highlights syndrome retentional.An honest-bilirubin increased predominantly combined (up to 10 times the normal value).-Presence of bile pigments in urine.-A persistent increase in alkaline phosphatase.-An increase of 5 'nucleotidases and GGT (no limit).-An increase in transaminases (SGOT, SGPT) to 5 to 10 times the normal value.-A decrease in the absorption of the assimilation of vitamin K which results in a decrease in the prothrombin time (blood clotting disorders).-An increase in CRP and fibrinogen is due which are markers indicating that there is inflammation, they ride in the days following the crisis with increased alpha2 and gamma globulins.
Bacteriology
In terms of bacteriological removal of bile in patients with cholangitis usually contains more than 100,000 cells / ml composed of two or more seeds. This percentage is even higher if:
- Fever above 39 ° C.- Shock.- Neuropsychiatric disorders.- Leucocytosis> 10,000.
The seeds are usually blood similar to those found in bile and are of intestinal origin. The germs most frequently found are Gram-negative bacilli (GNB), cocci gram (+), anaerobes responsible for severe sepsis.
Bacteria include the most common acute cholangitis lithiasis:
Gram-negative bacilli (60% to 80%):
- E. Coli.- Klebsiella pneumonia.- Pseudomonas aeruginosa.- Enterobacter cloacae.- Proteus morganii.
Gram-positive cocci (20% to 30%):
- Streptococcus faecalis.- Staphylococcus aureus.- Other types of streptococcus.
Anaerobic: 40%:
- Bacteroides fragilis.- Clostridium perfingens.- Especially if biliodigestives anastomoses.- Demonstration severe sepsis.- Postoperative septic complications.
FNS (Formula Blood Count)
A small-anemia without any particular characteristic.-A significant rise in white blood cells (WBC)> 15,000 éléments/mm3 in neutrophils (75-90%).
Liver
Highlights syndrome retentional.An honest-bilirubin increased predominantly combined (up to 10 times the normal value).-Presence of bile pigments in urine.-A persistent increase in alkaline phosphatase.-An increase of 5 'nucleotidases and GGT (no limit).-An increase in transaminases (SGOT, SGPT) to 5 to 10 times the normal value.-A decrease in the absorption of the assimilation of vitamin K which results in a decrease in the prothrombin time (blood clotting disorders).-An increase in CRP and fibrinogen is due which are markers indicating that there is inflammation, they ride in the days following the crisis with increased alpha2 and gamma globulins.
Bacteriology
In terms of bacteriological removal of bile in patients with cholangitis usually contains more than 100,000 cells / ml composed of two or more seeds. This percentage is even higher if:
- Fever above 39 ° C.- Shock.- Neuropsychiatric disorders.- Leucocytosis> 10,000.
The seeds are usually blood similar to those found in bile and are of intestinal origin. The germs most frequently found are Gram-negative bacilli (GNB), cocci gram (+), anaerobes responsible for severe sepsis.
Bacteria include the most common acute cholangitis lithiasis:
Gram-negative bacilli (60% to 80%):
- E. Coli.- Klebsiella pneumonia.- Pseudomonas aeruginosa.- Enterobacter cloacae.- Proteus morganii.
Gram-positive cocci (20% to 30%):
- Streptococcus faecalis.- Staphylococcus aureus.- Other types of streptococcus.
Anaerobic: 40%:
- Bacteroides fragilis.- Clostridium perfingens.- Especially if biliodigestives anastomoses.- Demonstration severe sepsis.- Postoperative septic complications.
08:49
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