Can acute cholangitis occur without a gall stone?

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Charcot's triad consists of fever, right upper quadrant (RUQ) pain, and jaundice, which are the clinical features of acute cholangitis. The confusion arises regarding whether RUQ pain and jaundice are direct results of cholangitis or if they stem from a gallstone obstructing the common bile duct, leading to infection. The discussion clarifies that while bacteria can enter the biliary system from the intestine, normal bile flow limits this. When a gallstone obstructs bile flow, it creates an environment conducive to bacterial growth, resulting in infection, fever, RUQ pain, and jaundice due to bile obstruction. RUQ pain can also be associated with other gallbladder conditions, highlighting the need for careful diagnosis.
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.
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