Asymptomatic FORM
The detected asymptomatic form than) (surgery) for gallstones (cholecystectomy, in which case cholangitis can work in a less impressive development mode, which is obviously more difficult to discover, especially in the absence of known history Bile.
Latent
It is rare, but possible. There are few clinical symptoms and are normally in the elderly. But latent cholangitis that involve a rapid movement Complications, as can be very brutal.
The latent cholangitis can externalize suddenly during an outbreak of acute gallstone disease or in other circumstances:
Instrumental opacification of bile ducts.
Endoscopic sphincterotomy.
Bile duct endoscopy.
Intraoperative manometric exploration.
Symptomatic forms
Forms purely painful.
Pure febrile forms.
Forms icteric pure.
Complicated form: "The acute> Cholangitis, jaundice Urem "
Fortunately rare, but still scared, it achieves a typical picture of cholangitis, but in the hour and the maximum in the coming days with a severe septic shock, which largely goes to the front, combined in a very short period of time renal organic. Age over 70 is an additional factor of gravity.
Clinically
Very quick installation of jaundice and is very intense, "said" flaming ".
Signs oftoxic shock.
And the quick installation of a renal organic (oliguria).
Sometimes disorders of consciousness (delirium syndrome).
Biologically
Thrombocytopenia 400 micromol / l.
Elevated blood urea> 20 mmol / l and creatinine> 110 mmol / l.
Hyperkalemia dangerous than 6 mmol / l.
Acidosis (retention of H + ions, which are eliminated).
It is a therapeutic emergency requiring extraction of bile duct, and possibly dialysis.
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