Colangite aguda

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When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Última revisão das evidências: 21 May 2026
Última atualização do tópico: 18 Jul 2023

Resumo

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • dor no quadrante superior direito/dor na parte superior do abdômen
  • sensibilidade no quadrante superior direito/na parte superior do abdome
  • icterícia
  • febre
Полная информация

Другие диагностические факторы

  • fezes claras
  • prurido
  • hipotensão
  • alterações do estado mental
Полная информация

Факторы риска

  • idade >50 anos
  • colelitíase
  • estenose benigna
  • estenose maligna
  • lesão do ducto biliar pós-procedimento
  • história de colangite esclerosante primária
  • história de colangite esclerosante secundária
  • Infecção pelo vírus da imunodeficiência humana (HIV)
  • inibidores de checkpoints imunológicos
  • Doença relacionada à IgG4
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • Hemograma completo
  • ureia sérica
  • creatinina sérica
  • Análise da gasometria arterial
  • testes séricos da função hepática
  • proteína C-reativa
  • potássio sérico
  • magnésio sérico
  • hemoculturas
  • painel da coagulação
  • ultrassonografia transabdominal
Полная информация

Исследования, проведение которых нужно рассмотреть

  • tomografia computadorizada (TC) do abdome com contraste intravenoso
  • colangiopancreatografia retrógrada endoscópica (CPRE)
  • colangiopancreatografia por ressonância magnética (CPRM)
  • colangiografia trans-hepática percutânea (CTP)
  • ultrassonografia endoscópica (USE)
Полная информация

Алгоритм лечения

Острый

agudamente doente

ПРОДОЛЖЕНИЕ

com coledocolitíase, colangite esclerosante primária ou colangiopatia por vírus da imunodeficiência humana (HIV)

Составители

Эксперты-консультанты

Christian Macutkiewicz, MD, FHEA, FRCS

Consultant General & Hepato-Pancreato-Biliary (HPB) Surgeon

Manchester Royal Infirmary

Manchester

UK

Раскрытие информации

CM declares that he has no competing interests.

Выражение благодарностей

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Douglas G. Adler, MD, FACG, AGAF, FASGE

Professor of Medicine

Director

Center for Advanced Therapeutic Endoscopy (CATE)

Porter Adventist Hospital

Centura Health

Denver

CO

Disclosures: DGA has consulted for Boston Scientific, Merit Medical, and Olympus, who make endoscopic retrograde cholangio-pancreatography (ERCP) products, and has also consulted for AbbVie Pharmaceuticals. He is an author of references cited in this topic.

Рецензенты

David J. Hackam, MD, PhD

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

PA

Раскрытие информации

DJH declares that he has no competing interests.

Todd Baron, MD

Professor of Medicine

Division of Gastroenterology & Hepatology

Mayo Clinic Rochester

Rochester

MN

Раскрытие информации

TB declares that he has no competing interests.

Dennis Freshwater, MB, BS, MD, FRCP

Consultant Hepatologist

The Liver and Hepatobiliary Unit

Queen Elizabeth Medical Care Unit

University Hospitals Birmingham NHS Foundation Trust

Birmingham

UK

Раскрытие информации

DF declares that he has no competing interests.

Bertus Eksteen, MRCP, PhD, MRC

Clinical Scientist

University of Birmingham

Honorary Consultant

Liver Transplant Unit

University Hospitals Birmingham NHS Foundation Trust

Birmingham

UK

Раскрытие информации

BE declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Kiriyama S, Kozaka K, Takada T, et al. Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17-30.Полный текст  Аннотация

Miura F, Okamoto K, Takada T, et al. Tokyo guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis. J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):31-40.Полный текст  Аннотация

National Institute for Health and Care Excellence. Gallstone disease: diagnosis and management. October 2014 [internet publication].Полный текст

Gomi H, Solomkin JS, Schlossberg D, et al. Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):3-16.Полный текст  Аннотация

Mukai S, Itoi T, Baron TH, et al. Indications and techniques of biliary drainage for acute cholangitis in updated Tokyo Guidelines 2018. J Hepatobiliary Pancreat Sci. 2017 Oct;24(10):537-49.Полный текст  Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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