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PubMed · 7203343

[Inflammatory biliary tract diseases].

M Mörl
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Abstract

Acute cholangitis, as a serious, sometimes life-threatening clinical picture, is often clearly distinguishable by virtue of its clinical symptomatology (fever, upper abdominal pain, possibly also jaundice). Chronic cholangitis, primary sclerosing cholangitis and chronic destructive, non-suppurative cholangitis are, although clearly defined, without symptoms in the early stages, and can be diagnosed only on the basis of long-term observations. Clinical symptomatology, diagnosis and differential diagnosis, therapy, course and prognosis are discussed.

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CholangitisCholelithiasisChronic DiseaseDiagnosis, DifferentialHumansLiver Cirrhosis, BiliaryEnglish AbstractJournal Article

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M Mörl. 1981-01-22. [Inflammatory biliary tract diseases].. https://pubmed.ncbi.nlm.nih.gov/7203343/

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[Clinical manifestations of cholelithiasis and its complications].

Gallbladder stones remain asymptomatic over a long period. The biliary colic is the typical pain caused by these stones. Dyspeptic symptoms seem to be unrelated to the presence of gallstones. Acute cholecystitis, a serious complication of gallstone disease, spans a wide spectrum of clinical findings. The typical signs are right upper abdominal pain and tenderness, fever, leucocytosis and Murphy's sign. 35% of patients experience gallbladder empyema or perforation. Localized gallbladder perforation, characterized by high fever, severe right upper abdominal pain and tenderness and a palpable mass is often difficult to distinguish from acute cholecystitis. Free perforation into the abdominal cavity causes diffuse peritonitis. Gallbladder perforation into the lumen of an adjacent organ produces fistulas, mostly with minimal symptoms or a pain relief after decompression of the inflamed gallbladder. Air in the bile ducts and on some occasions bile-acid-induced diarrhea may result. Rarely, the perforation of large stones leads to an occlusion of the GI tract and results in a gallstone ileus. Common bile duct stones may be asymptomatic or cause bile duct obstruction with biliary colics and jaundice. Acute bacterial cholangitis characterized by Charcot's triad (pain, jaundice and fever) and the acute biliary pancreatitis with its typical symptoms are the serious complications of common bile duct stones, associated with a high mortality rate. The clinical manifestations of a gallstone disease and its complications reveal important diagnostic features, but the most important diagnostic features, modalities are the imaging procedures. They are decisive for an accurate therapy.

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