Biliary Tract Infections and Liver Abscesses

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Biliary Tract Infections and Liver Abscesses создатель Mind Map: Biliary Tract Infections and Liver Abscesses

1. Ascending Cholangitis

1.1. Clinical Syndrome

1.1.1. Charcot's Triad Fever RUQ pain Jaundice

1.1.2. Nausea / Vomiting

1.1.3. Frank Sepsis Fever Tachycardia Hypotension Tachpnea

1.1.4. Reynold's Pentad Charcot's Triad + sepsis and AMS

1.2. Pathophysiology

1.2.1. Acute bacterial infection of bile ducts From obstruction of Common Bile Duct Causes of Obstruction Bacteria gain access via lymphatics portal venous blood retrograde from duodenum Pathogens E. coli Klebsiella Streptococcus Enterobacter Pseudomonas HIV cholangiopathy Parasitic infection

1.3. Diagnosis

1.3.1. Clinical diagnosis Charcot's Triad Reynold's Pentad

1.4. Treatment

1.4.1. Broad Spectrum ABX Piperacillin / Tazobactam Imipenem or Meropenem Ceftriaxone or Cefepime + Metronidazole

1.4.2. Surgery

2. Acute Cholecystitis

2.1. Clinical Syndrome

2.2. Pathophysiology

2.2.1. Obstruction of cystic duct Gallstones Elevated intraluminal pressure of gallbladder inflammation Translocation of bacteria

2.2.2. Pathogens E. coli Enterococcus Anaerobes

2.3. Diagnosis

2.4. Treatment

2.4.1. Analgesics

2.4.2. Electrolytes

2.4.3. Hydration

2.4.4. ABX

2.4.5. Surgery

2.5. Acute Cholecystitis

3. Liver Abscesses

3.1. Clinical Syndrome

3.1.1. Fever, Chills, night sweats, malaise, nausea, vomiting

3.1.2. RUQ pain

3.2. Pathophysiology

3.2.1. 50% develop from cholangitis

3.2.2. Else bacteremia hepatic artery Portal vein Diverticulitis Cholecystitis Trauma

3.2.3. Pathogens E. coli Klebsiella Streptococcus Staphylococcus Anaerobes Entamoeba histolytica Traveler's disease Transmission Liver Abscess

3.3. Diagnosis

3.3.1. Ultrasound

3.4. Treatment

3.4.1. Drain abscess culture aspirate

3.4.2. Broad spectrum ABX