Acute cholangitis: Diagnosis

Q: Laboratory evidence of cholestasis ____________ imaging with biliary dilation or evidence of the underlying etiology is required to make a diagnosis of acute cholangitis? (select one)

A) and

B) or

Answer: A

A diagnosis of acute cholangitis requires one of the following:

• Fever and/or shaking chills.
• Laboratory evidence of an inflammatory response via abnormal WBC, high CRP, or any lab suggestive of inflammation

and both of the following:

• Evidence of cholestasis: Bilirubin ≥2 mg/dL or abnormal liver chemistries (elevated alkaline phosphatase, gamma-glutamyl transpeptidase, alanine aminotransferase, or aspartate aminotransferase, to >1.5 times the upper limit of normal).
• Imaging with biliary dilation or evidence of the underlying etiology (eg, a stricture, stone, or stent).

#hepatology

References:

1. Nezam H Afdhal - https://www.uptodate.com/contents/acute-cholangitis-clinical-manifestations-diagnosis-and-management Link: https://www.uptodate.com/contents/acute-cholangitis-clinical-manifestations-diagnosis-and-management @ UptoDate (last accessed February 10, 2024)

2. Sokal A, Sauvanet A, Fantin B, de Lastours V. Acute cholangitis: Diagnosis and management. J Visc Surg. 2019 Dec;156(6):515-525. doi: 10.1016/j.jviscsurg.2019.05.007. Epub 2019 Jun 24. PMID: 31248783.