Clinical forms of cholangitis
Asymptomatic
The asymptomatic discovery when one operates (during surgery) for gallstones (cholecystectomy), cholangitis in this case can evolve sue a less evocative, the discovery is obviously more difficult especially in the absence of background Bile known [8].
Crude form or LATENT
It is rare but possible. There are few clinical signs are mainly in the elderly. However, even latent, this will require a quick movement cholangitis because of complications may be very brutal.
The latent cholangitis may express itself violently, during an outbreak of acute gallstone disease, or in various circumstances:
- Opacification instrumental biliary tract.
- Endoscopic sphincterotomy.
- Common duct endoscopy.
- Explorations intraoperative manometric.
Symptomatic forms
- Forms purely painful.
- Pure febrile forms.
- Forms icteric pure.
Complicated shape, "cholangitis ACUTE icterus UREMIGENE"
- Fortunately rare, but always fear, she realizes a typical picture of cholangitis but is, in the hours and the maximum in the next few days, accompanied by a severe septic shock that goes largely to the fore, combining in one period very short renal organic. Age greater than 70 is an additional factor of gravity.
Clinically:
It jaundice installation very fast and becomes very intense, says "flamboyant".
- Signs of toxic shock infectious.
- And the rapid onset renal organic (oliguria).
- Sometimes disorders of consciousness (delirium).
Biologically:
- Thrombocytopenia <150,000 mm3.
- Direct bilirubin can be> 400 micromol / l.
- Increase in blood urea> 20 mmol / l and creatinine> 110 mmol / l.
- Hyperkalemia dangerous above 6 mEq / l.
- Acidosis (retention of H + ions which are not eliminated).
This is an emergency treatment will require unblocking the bile duct and eventually hemodialysis.
The asymptomatic discovery when one operates (during surgery) for gallstones (cholecystectomy), cholangitis in this case can evolve sue a less evocative, the discovery is obviously more difficult especially in the absence of background Bile known [8].
Crude form or LATENT
It is rare but possible. There are few clinical signs are mainly in the elderly. However, even latent, this will require a quick movement cholangitis because of complications may be very brutal.
The latent cholangitis may express itself violently, during an outbreak of acute gallstone disease, or in various circumstances:
- Opacification instrumental biliary tract.
- Endoscopic sphincterotomy.
- Common duct endoscopy.
- Explorations intraoperative manometric.
Symptomatic forms
- Forms purely painful.
- Pure febrile forms.
- Forms icteric pure.
Complicated shape, "cholangitis ACUTE icterus UREMIGENE"
- Fortunately rare, but always fear, she realizes a typical picture of cholangitis but is, in the hours and the maximum in the next few days, accompanied by a severe septic shock that goes largely to the fore, combining in one period very short renal organic. Age greater than 70 is an additional factor of gravity.
Clinically:
It jaundice installation very fast and becomes very intense, says "flamboyant".
- Signs of toxic shock infectious.
- And the rapid onset renal organic (oliguria).
- Sometimes disorders of consciousness (delirium).
Biologically:
- Thrombocytopenia <150,000 mm3.
- Direct bilirubin can be> 400 micromol / l.
- Increase in blood urea> 20 mmol / l and creatinine> 110 mmol / l.
- Hyperkalemia dangerous above 6 mEq / l.
- Acidosis (retention of H + ions which are not eliminated).
This is an emergency treatment will require unblocking the bile duct and eventually hemodialysis.
08:51
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