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* acute cholecystitis, ascending cholangitis,
 #437919  
  got2study2pass - 08/14/09 20:19
 
  how are these different. acute cholecystitis is inflammation of gallbladder and stones inside the gallbladder. ascendign cholangiitis is stone in the CBD but also stones in the gallbladder. then we have a condition in which there is a stone in the cystic duct.

i mean how do u differentiate these clinically. al have RUQ pain and fever and luekocytosis. so im kind of confused.
 
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* Re:acute cholecystitis, ascending cholangitis,
#1843662
  yazdoc - 08/14/09 22:30
 
  acute cholecystitis: stone in cystic duct/this is inflammation and not infection/ RUQ pain/ fever if there will we low grade/ no jaundice since its not obstructing CBD/ murphys sign +/ first step is USG and if not conclusive HIDA scan

choledocholithiasis: stone in CBD/ obstructive jaundice(jaundice is big thing here)/ RUQ or epigastric pain/ total and direct bilirubin elevated as well as alkaline phosphatase/ can lead to cholangitis/ usg done but cant proficiently see CBD so gold standard is ERCP

cholangitis: infection / deadly
RUQ pain+jaundice+fever(very ill patient)
septic shock and altered mental status can also be seen
hyperbilirubinemia/ leucocytosis
can lead to hepatic abscess which has high mortality

hope this helps
 
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* Re:acute cholecystitis, ascending cholangitis,
#1844263
  got2study2pass - 08/15/09 19:01
 
  thanks yaz doc, it definitly helps

 
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* Re:acute cholecystitis, ascending cholangitis,
#1844265
  medicalstudent - 08/15/09 19:06
 
  great explaining yazdoc.  
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* Re:acute cholecystitis, ascending cholangitis,
#3293769
  avicenna_the_great - 05/14/16 23:19
 
  thanks.  
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