EM Cases · Biliary disease — colic, cholecystitis, cholangitis
Ascending cholangitis — Grade III resus station
ACEM Fellowship OSCE resus station testing TG18 cholangitis recognition, Hour-1 sepsis care with antibiotic doses, and urgent ERCP source control.
On this page
Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
An elderly man with Charcot triad who becomes hypotensive and confused, with a dilated CBD on bedside ultrasound.
Station brief
Format. Clinical-management (resus) station, 11 minutes total — 4 minutes reading, 7 minutes active assessment. You are the Emergency Medicine consultant leading the resuscitation.
Candidate instructions. Manage the patient from the end of the trolley handover. State actions and reasoning aloud. The examiner plays the nursing team.[1]
References3ShowHide
- [1]Kiriyama S, Kozaka K, Takada T, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). Journal of Hepato-Biliary-Pancreatic Sciences, 2018.PMID 29032610
- [3]Gomi H, Solomkin JS, Takada T, et al. Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 2018.PMID 29090866
- [5]Miura F, Okamoto K, Takada T, et al. Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis and cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 2018.PMID 28941329