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Acute cholangitis in Singapore.

R K Chew, S Lim, C Cheng

    Annals of the Academy of Medicine, Singapore
    |April 1, 1986
    PubMed
    Summary
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    Acute calculous cholangitis presents with pain but often lacks the complete Charcot

    Area of Science:

    • Gastroenterology
    • Hepatobiliary Surgery

    Background:

    • Acute calculous cholangitis is a common biliary tract infection.
    • Early diagnosis and treatment are crucial for patient outcomes.

    Purpose of the Study:

    • To analyze the clinical presentations, treatment strategies, and complications of acute calculous cholangitis.
    • To identify risk factors associated with higher mortality.

    Main Methods:

    • Retrospective analysis of 115 patients with acute calculous cholangitis.
    • Review of patient demographics, symptoms, diagnostic findings, treatment interventions, and outcomes.

    Main Results:

    • Pain was the most frequent symptom (95.7%), but only 35.7% exhibited complete Charcot's triad.
    • 21.7% of patients presented with septic shock.

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  • Escherichia coli and Klebsiella were the most common pathogens.
  • Overall mortality was 16.5%, with patients over 60 presenting in shock having a 40% mortality rate.

    • Conclusions:

    • Acute calculous cholangitis frequently presents atypically, without the full Charcot's triad.
    • Prompt surgical intervention (cholecystectomy and common bile duct exploration) is standard.
    • Septic shock and advanced age are significant predictors of mortality.