acute cholangitis

 Q: What are the criteria to make clinical diagnosis of acute cholangitis? 

Answer: The objective of this question is to highlight the fact that the diagnosis of acute cholangitis requires - all four - systemic, hepatic, laboratory as well as radiological evidence.

Diagnosis of acute cholangitis requires demonstration of systemic inflammation with one of the following: 

• Fever and/or shaking chills or any laboratory evidence such as leukocytosis or elevated CRP

And both of the following: 

• Evidence of cholestasis with bilirubin ≥2 mg/dL, elevated alkaline phosphatase, GGTP, or transaminases 1.5 times the normal. 
• Radiological evidence such as ultrasound

#hepatology

References:

1. An Z, Braseth AL, Sahar N. Acute Cholangitis: Causes, Diagnosis, and Management. Gastroenterol Clin North Am. 2021 Jun;50(2):403-414. doi: 10.1016/j.gtc.2021.02.005. Epub 2021 Apr 23. PMID: 34024448.

2. Mosler P. Diagnosis and management of acute cholangitis. Curr Gastroenterol Rep. 2011 Apr;13(2):166-72. doi: 10.1007/s11894-010-0171-7. PMID: 21207254.

3. 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.