The Intern At Work: Internal Medicine cover image

The Intern At Work: Internal Medicine

195. Biliary Off Track - An Approach to Cholecystitis and Cholangitis

May 21, 2023
15:30

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Quick takeaways

  • Charcot's triad for cholangitis includes fever, right upper quadrant pain, and jaundice, which surgeons expanded to include altered mental state and shock forming Reynolds-Pentad.
  • Diagnosing acute cholecystitis and cholangitis involves considering history, physical exam findings, laboratory, and imaging results for appropriate management interventions.

Deep dives

Evolution of Charcot's Triad to Reynolds-Pentad

Originally described by Dr. Charcot in the 1880s, Charcot's triad for cholangitis consisted of fever, right upper quadrant pain, and jaundice. Surgeons expanded this triad with altered mental state and shock, forming Reynolds-Pentad. Tokyo guidelines now provide diagnostic criteria for gallstone diseases, including acute cholecystitis and cholangitis.

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