Acute Cholecystitis Vs Acute Ascending Cholangitis - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
USMLE Articles
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam

Thread Tools Search this Thread Display Modes
Old 05-17-2010
USMLE Forums Scout
Steps History: Not yet
Posts: 97
Threads: 52
Thanked 143 Times in 53 Posts
Reputation: 143
Liver Acute Cholecystitis Vs Acute Ascending Cholangitis

How do we differentiate between acute cholecystitis and acute ascending cholagnitis in USMLE.
Both conditions present acutely with right upper quadrant tenderness and pain and both conditions are predisposed by gallstones, you know that fertile fatty female in her fifties.

Please help
Reply With Quote Quick reply to this message

Old 05-17-2010
ath.pantelis's Avatar
USMLE Forums Addict
Steps History: 1+CK+CS
Posts: 187
Threads: 4
Thanked 409 Times in 130 Posts
Reputation: 439

One the one hand, acute cholangitis is a true medical emergency, with the patient being septic, toxic and shock, i.e. the pentad of Raynolds should make you think more of cholangitis than cholecystitis. Of course, this doesn't mean that cholocystitis may not present in this way, but in a pt presenting very ill (and for the shake of USMLE) always suspect cholangitis.

One the other hand, suspect this entity in cases that suggest a possibility of disturbance of the normal flow of bile from the biliary tree though the ampulla to the duodenum. Conditions such as underlying pancreatic Ca, history of ERCP, ampullary stenting or alteration of the anatomy of the region in any way are highly suggestive. Again, gallstones constitute the most frequent underlying cause, but the abovementioned culprits are red alerts for cholangitis.

The definitive differential can be given only by means of imaging, but those clinical hints may prove helpful when in doubt on no imaging option is given in the questions stem or the available answers.
Reply With Quote Quick reply to this message
The above post was thanked by:
Ainat (01-28-2015), erickven (02-09-2017), kcub (11-24-2012), lichen70 (09-28-2015), pkul85 (10-04-2013), rasheed (05-17-2010), Taiwan_Guy (07-24-2011)
Old 01-28-2015
USMLE Forums Scout
Steps History: Step 1 Only
Posts: 12
Threads: 0
Thanked 3 Times in 3 Posts
Reputation: 13

Good find. Thanks for sharing.

To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message


Gastroenterology-, Surgery-

Quick Reply

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Please enter a password for your user account. Note that passwords are case-sensitive.
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Where you live. Leave blank if you don't want to tell.


Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Similar Threads
Thread Thread Starter Forum Replies Last Post
Acute cholecystitis vs biliary colic lemontea88 USMLE Step 1 Forum 6 02-13-2012 08:16 AM
Acute Abdomen Case 13monument USMLE Step 2 CK Forum 5 03-20-2010 02:53 AM
Management of Acute Calcular Cholecystitis mosallam USMLE Step 2 CK Forum 4 03-19-2010 10:43 PM
Acute Intermittent Porphyria Dr. N Elham USMLE Step 1 Forum 1 12-12-2009 06:05 AM
Acute pancreatitis-causes docspike USMLE Step 1 Mnemonics 0 10-21-2009 01:07 AM

Find Us on Facebook
Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2021, vBulletin Solutions, Inc.
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2021 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2019)