Can acute cholangitis occur without a gall stone?

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SUMMARY

Acute cholangitis can occur without the presence of a gallstone, although the condition is often associated with gallstone obstruction of the common bile duct. Charcot's triad, which includes fever, right upper quadrant (RUQ) pain, and jaundice, describes the clinical features of acute cholangitis. RUQ pain and jaundice can arise from the infection itself, independent of gallstone obstruction. Bacterial infection can proliferate in the biliary tree when bile flow is obstructed, leading to these symptoms.

PREREQUISITES
  • Understanding of Charcot's triad in acute cholangitis
  • Knowledge of biliary anatomy and function
  • Familiarity with bacterial infections in the hepatobiliary system
  • Basic concepts of jaundice and its causes
NEXT STEPS
  • Research the pathophysiology of acute cholangitis
  • Study the role of bacteria in biliary infections
  • Learn about diagnostic criteria for acute cholangitis
  • Explore treatment options for cholangitis without gallstones
USEFUL FOR

Medical professionals, particularly gastroenterologists and surgeons, as well as students studying hepatobiliary diseases and infections.

sameeralord
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Hello everyone,

Charcot's triad is there to describe the clinical features of acute cholangitis. They are

1.Fever
2. Right upper quadrant pain
3. Jaundice

2 and 3 in charcot's triad is confusing to me. As I want to know if they occur due to cholangitis (infection) or due to gall stone obstructing common bile duct and then getting infected causing cholangitis. Is this charcot's triad made assuming that a gall stone causes cholangitis, or even without a stone would 3 features mentioned in Charcot's triad occur in acute cholangitis.

Thanks :)
 
sameeralord said:
Hello everyone,

Charcot's triad is there to describe the clinical features of acute cholangitis. They are

1.Fever
2. Right upper quadrant pain
3. Jaundice

2 and 3 in charcot's triad is confusing to me. As I want to know if they occur due to cholangitis (infection) or due to gall stone obstructing common bile duct and then getting infected causing cholangitis. Is this charcot's triad made assuming that a gall stone causes cholangitis, or even without a stone would 3 features mentioned in Charcot's triad occur in acute cholangitis.

Thanks :)

A few bacteria are able to make it from the intestine to the ducts. However, the normal flow of bile keeps this number to a minimum. Upon obstruction with a gall stone the bile flow stops and leads to an environment in which the microbes can grow and multiply. This allows the bacteria to move in a retrograde fashion and gain access to the biliary tree. The infection can progress and possibly spread and can present as fever. The involvement of hepatobiliary structures can present as RUQ pain. The jaundice is due to excess pigments in the blood (since there's an obstruction). Note hat RUQ pain is common to other diseases involving the gall bladder.
:smile:
 

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