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Encyclopedia > Ascending cholangitis
Ascending cholangitis
Classification & external resources
ICD-10 K83.9
ICD-9 576.1

Cholangitis is one of a number of problems associated with the bile duct. Cholangitis is bacterial infection of the biliary tract. It results from bile stasis due to chronic obstruction, usually by stones. It is a common, life-threatening complication of choledocholithiasis. It is a consequence of bacterial infection superimposed on an obstructed biliary system. The infecting organisms are usually gram-negative bacilli (eg, E coli, Klebsiella, Pseudomonas, and Enterococcus). Anaerobes may be cultured in 15% of cases. The clinical syndrome of cholangitis is characterized by pain, jaundice, and fever (Charcot's triad). In addition, the presence of hypotension and mental confusion (Reynold's pentad) is suggestive of severe septicemia. The typical clinical picture is present in only 50% of cases. Laboratory studies show cholestasis, variable transaminase levels, leukocytosis, and positive blood cultures. Findings on ultrasound examination are the same as those for choledocholithiasis. When acute cholangitis is suspected, the patient should be hospitalized. Fluid resuscitation and antibiotics are the key interventions, and antibiotic treatment should be targeted against gram-negative organisms and, possibly, anaerobes. Commonly used drugs include ampicillin, gentamicin sulfate (Garamycin) and metronidazole (Flagyl, Metro IV, Protostat), or ciprofloxacin (Cipro) with or without metronidazole. The mainstay of therapy, however, is the establishment of biliary drainage, which can be accomplished endoscopically or percutaneously. Timing of the procedure depends on severity of the clinical presentation. If the patient's condition is too unstable for ERCP, percutaneous transhepatic drainage can tide the patient over the acute crisis until definitive therapy can be planned. In all other cases, ERCP to determine the cause of the obstruction and provide drainage should be performed as soon as possible. Image File history File links Broom_icon. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // K00-K93 - Diseases of the digestive system (K00-K14) Diseases of oral cavity, salivary glands and jaws (K00) Disorders of tooth development and eruption (K01) Embedded and impacted teeth (K02) Dental caries (K03) Other diseases of hard tissues of teeth (K04) Diseases of pulp and periapical tissues (K040) Pulpitis (K05... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... Primary sclerosing cholangitis (PSC) is an inflammatory disease of the bile duct, which leads to cholestasis (blockage of bile transport to the gut). ... X-Ray of the bile duct during a laprascopic cholecystectomy A bile duct is any of a number of long tube-like structures that carry bile. ... Choledocholithiasis is the presence of a gallstone in the common bile duct. ... Phyla Actinobacteria Aquificae Chlamydiae Bacteroidetes/Chlorobi Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Lentisphaerae Nitrospirae Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Verrucomicrobia Bacteria (singular: bacterium) are unicellular microorganisms. ... An infection is the detrimental colonization of a host organism by a foreign species. ... This article or section does not adequately cite its references or sources. ... Jaundice, also known as icterus (attributive adjective: icteric), is a yellowing of the skin, conjunctiva (clear covering over the sclera, or whites of the eyes) and mucous membranes caused by increased levels of bilirubin in the human body (or the body of another red blooded animal). ... Sepsis (in Greek Σήψις) is a serious medical condition caused by a severe systemic infection leading to a systemic inflammatory response. ... Leukocytosis is an elevation of the white blood cell count (the leukocyte count) above the normal range. ... Ultrasound is sound with a frequency greater than the upper limit of human hearing, this limit being approximately 20 kilohertz (20,000 hertz). ... Choledocholithiasis is the presence of a gallstone in the common bile duct. ... Endoscopic retrograde cholangiopancreatography (ERCP) is endoscopy of the biliary tree and the pancreatic duct. ...


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