What are the signs and symptoms of acute cholangitis?

Updated: Dec 29, 2017
  • Author: Timothy M Scott, DO; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Symptoms include the following:

  • Charcot's triad consists of fever, RUQ pain, and jaundice. It is reported in up to 50-70% of patients with cholangitis. However, recent studies believe it is more likely to be present in 15-20% of patients.

  • Fever is present in approximately 90% of cases.

  • Abdominal pain and jaundice is thought to occur in 70% and 60% of patients, respectively.

  • Patients present with altered mental status 10-20% of the time and hypotension approximately 30% of the time. These signs, combined with Charcot's triad, constitute Reynolds pentad.

  • Consequently, many patients with ascending cholangitis do not present with the classic signs and symptoms. [11]

  • Most patients complain of RUQ pain; however, some patients (ie, elderly persons) are too ill to localize the source of infection.

Other symptoms include the following:

  • Jaundice

  • Fever, chills, and rigors

  • Abdominal pain

  • Pruritus

  • Acholic or hypocholic stools

  • Malaise

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