Acute cholangitis: The Daily PANCE Blueprint
A 42-year-old with RUQ pain, fever, and jaundice shows elevated ALP + bilirubin. What condition is suspected?
A. Acute cholecystitis
B. Acute cholangitis
C. Hepatitis A
D. Pancreatitis
E. Gastritis
Answer and topic summary
The answer is B. Acute cholangitis
Acute cholangitis is an ascending bacterial infection of the biliary tree caused by biliary obstruction with superimposed infection, most commonly from choledocholithiasis. Typical pathogens include E. coli, Klebsiella, and Enterobacter.
The classic presentation is Charcot’s triad, which consists of:
- Fever
- Jaundice
- Right upper quadrant (RUQ) abdominal pain
Severe cases may progress to Reynold’s pentad, which adds:
- Altered mental status
- Hypotension (shock)
Laboratory findings typically demonstrate a cholestatic pattern, including elevated alkaline phosphatase, bilirubin, and AST/ALT.
Management requires hospital admission, IV fluids, and broad-spectrum antibiotics (e.g., ceftriaxone plus metronidazole), followed by urgent biliary decompression, most commonly via ERCP with sphincterotomy.
View blueprint lesson
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
