Summary
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 右上象限 (RUQ)疼痛/上腹痛
- 右上腹/上腹压痛
- 黄疸
- 发热
其他诊断因素
- 陶土色便
- 瘙痒
- 低血压
- 精神状态改变
危险因素
- 50 岁以上
- 胆石症
- 良性狭窄
- 恶性狭窄
- 胆道术后损伤
- 原发性硬化性胆管炎病史
- 继发性硬化性胆管炎病史
- HIV 感染
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- 全血细胞计数（FBC）
- 血清尿素
- 血清肌酐
- 动脉血气 (ABG) 分析
- 血清肝功能检查
- C 反应蛋白 (CRP)
- 血钾
- 血清镁
- 血液培养
- 凝血检查组合
- 内镜逆行胰胆管造影术 (ERCP)
- 经腹超声
გასათვალისწინებელი კვლევები
- 使用静脉造影剂的腹部增强 CT
- 磁共振胰胆管造影术 (MRCP)
- 经皮经肝穿刺胆道造影 (PTC)
- 外科开腹行胆总管探查
ახალი ტესტები
- 超声内镜 (EUS)
მკურნალობის ალგორითმი
急性发病
合并胆总管结石、原发性硬化性胆管炎或者 HIV 相关性胆管病变。
კონტრიბუტორები
ავტორები
Douglas G. Adler, MD, FACG, AGAF, FASGE
Professor of Medicine
Division of Gastroenterology
Department of Internal Medicine
Huntsman Cancer Institute
University of Utah
Salt Lake City
UT
გაფრთხილება:
DGA has consulted for BSC and Merit, who make endoscopic retrograde cholangio-pancreatography (ERCP) products. He is also an author of references cited in this topic.
მადლიერება
Dr Douglas G. Adler would like to gratefully acknowledge Dr Andrew S. Fedoravicius, a previous contributor to this topic.
გაფრთხილება:
ASF declares that he has no competing interests.
რეცენზენტები
David J. Hackam, MD, PhD
Associate Professor of Pediatric Surgery
University of Pittsburgh School of Medicine
Pittsburgh
PA
გაფრთხილება:
DJH declares that he has no competing interests.
Todd Baron, MD
Professor of Medicine
Division of Gastroenterology & Hepatology
Mayo Clinic Rochester
Rochester
MN
Disclosures
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
Disclosures
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
Disclosures
BE declares that he has no competing interests.
Differentials
- 急性胆囊炎
- 消化性溃疡疾病
- 急性胰腺炎
More DifferentialsGuidelines
- 急性胆管炎和胆囊炎的 TG18 治疗策略
- 关于急性胆道感染初期管理及急性胆管炎管理流程图的 2018 版东京指南
More GuidelinesPatient information
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More Patient informationVideos
静脉穿刺和抽血的动画演示
中心静脉置管的动画演示
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