EM · Biliary disease

Biliary disease — biliary colic, acute cholecystitis and ascending cholangitis

Also known as Biliary colic · Acute cholecystitis · Ascending cholangitis · Acute cholangitis · Gallstone disease · Charcot triad

The biliary disease spectrum — biliary colic, the transient cystic duct obstruction with self-limiting post-prandial RUQ pain managed by elective cholecystectomy; acute cholecystitis, the sustained obstruction with RUQ tenderness, fever, a positive Murphy sign, ultrasound wall thickening over 3 mm and pericholecystic fluid, managed with analgesia, antibiotics covering enteric Gram-negatives and anaerobes, and early laparoscopic cholecystectomy; and ascending cholangitis, the obstructed infected biliary tree with Charcot triad and Reynolds pentad, managed with antibiotics, fluid resuscitation and urgent ERCP decompression. ACEM-primary, globally tagged.