Book chapter
Acute Cholangitis
Acute Care Surgery and Trauma, pp 576-588
2016
Abstract
Acute bacterial cholangitis remains a common surgical emergency. An increase in intrabiliary pressure due to obstruction is postulated to play an important role in the pathogenesis of acute cholangitis. In a retrospective study of patients with community acquired severe acute cholangitis, blood cultures were positive in 160 of 676 patients. Another retrospective study of 65 patients with acute cholangitis where bile cultures were taken after biliary drainage found that only 22 of 65 had positive bile cultures. The clinical impact of extended spectrum beta-lactamase (ESBL)-positive strains is not well studied in acute cholangitis but one retrospective study noted that patients with ESBL-positive strains isolated from blood or bile had a significantly higher 30-day mortality rate compared to those with ESBL-negative strains. Kogure et al. studied 18 patients prospectively where cefmetazole and meropenem were used as initial antibiotic therapy for patients with moderate and severe acute cholangitis, respectively.
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Details
- Title
- Acute Cholangitis
- Creators
- Adrian W. OngShannon M. Foster
- Contributors
- Stephen M. Cohn (Editor)Matthew O. Dolich (Editor)Kenji Inaba (Editor)
- Publication Details
- Acute Care Surgery and Trauma, pp 576-588
- Publisher
- CRC Press
- Edition
- 2
- Resource Type
- Book chapter
- Language
- English
- Academic Unit
- Surgery
- Other Identifier
- 991022020737704721