Abordaje diagnóstico en la colangitis aguda

Abstract

Introduction: Acute cholangitis is an infection of the bile ducts, primarily as a result of bile duct obstruction. The main causes are choledocolithiasis and neoplasms. The clinical diagnosis is based on the Charcot triad (pain, fever, jaundice), but the latter's insufficient sensitivity led to the introduction of a new score validated by the 2013/2018 Tokyo Guidelines. There is a great variety of bacteria involved, the main ones being Escherichia Coli and Klebsiella spp. The presence of a biliary endoprotesis (stent) is an identified risk factor associated with infections by multi-drug resistant pathogens. Together with antimicrobial therapy, endoscopic biliary drainage or through interventional radiology. Mortality ranges from 5% to 10%, according to comorbidities, treatment carried out in a timely manner and the degree of disease staging. Objective: Identify the main elements to consider for the timely diagnosis of acute cholangitis. Method: Bibliographic review of updated academic articles with studies of the last 5 years, obtained in Pubmed, Science Direct, searches in the Cochrane Registry of Hepato-biliary Controlled Trials and in the Central Registry of Cochrane Controlled Trials (CENTRAL) in the Cochrane Library Conclusion: The diagnosis of acute cholangitis is based on the presence of the charcot triad, associated with analytical alterations that reflect an inflammatory state, alteration in liver test analyzes, and bile duct abnormalities in imaging tests.