最后审阅: 17 四月 2021
最后更新: 11 二月 2020

小结

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

  • 陶土样大便
  • 瘙痒
  • 低血压
  • 精神状态改变

危险因素

  • 年龄>50 岁
  • 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

诊断性检查

首要检查

  • 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
  • 经腹超声
  • 内镜逆行胰胆管造影术 (ERCP)

需考虑的检查

  • 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)
  • 超声内镜 (EUS)

治疗流程

撰稿人

Professor of Medicine

Division of Gastroenterology

Department of Internal Medicine

Huntsman Cancer Institute

University of Utah

Salt Lake City

UT

利益声明

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

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

Manchester Royal Infirmary

Manchester

UK

利益声明

CM declares that he has no competing interests.

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

PA

利益声明

DJH declares that he has no competing interests.

Professor of Medicine

Division of Gastroenterology & Hepatology

Mayo Clinic Rochester

Rochester

MN

利益声明

TB declares that he has no competing interests.

Consultant Hepatologist

The Liver and Hepatobiliary Unit

Queen Elizabeth Medical Care Unit

University Hospitals Birmingham NHS Foundation Trust

Birmingham

UK

利益声明

DF declares that he has no competing interests.

Clinical Scientist

University of Birmingham

Honorary Consultant

Liver Transplant Unit

University Hospitals Birmingham NHS Foundation Trust

Birmingham

UK

利益声明

BE declares that he has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Head of Editorial, BMJ Best Practice

利益声明

AE declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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