Abdominal pain, fever and jaundice
Introduction
Introduction Charcot triad refers to abdominal cramps (high pain in the right upper abdomen), chills fever and jaundice, which are typical symptoms of acute suppurative cholangitis. The causes are mostly bile duct stones. The typical manifestation of the Charcot triad is acute cholangitis. Clinical practice has proved that patients with jaundice-type viral hepatitis, in addition to bed rest, attention to nutrition, the right amount of vitamins, due to abnormal bilirubin metabolism caused by elevated levels of bilirubin in the skin, mucous membranes and sclera Illness.
Cause
Cause
Cause
Most of the causes are bile duct stones, suspected to be jaundice hepatitis.
Clinical practice has proved that patients with jaundice-type viral hepatitis, which are characterized by elevated levels of bilirubin in the blood, appear in the skin, mucous membranes and sclera, are hot, flaming, invaginated, or massive Bleeding, liver and kidney yang failure can occur, yin and yellow treatment for a long time, can be turned into accumulation, bulging. In general, the prognosis of Yanghuang is good, only the acute yellow evil enters the heart camp, blood and blood, and the prognosis is poor. As for the yin and yellow, if the yang is gradually recovered, the jaundice will gradually retreat, and the prognosis is better; if the yin and yellow are cured for a long time, the phlegm and blood will be burned and the jaundice will be deepened.
Examine
an examination
Related inspection
Erythrocyte serum total bilirubin alpha-fetoprotein variant (AFPV) regression thermocoil (BR) transcutaneous cholangiography cholangiography
1, the onset is often abrupt, sudden violent pain under the xiphoid or right upper abdomen, generally persistent.
2, followed by chills and relaxation type high fever, body temperature can exceed 40 °C. Often accompanied by nausea and vomiting. Most patients have jaundice, but the depth of the jaundice may be inconsistent with the severity of the condition.
3. Nearly half of the patients have symptoms of central nervous system depression such as irritability, disturbance of consciousness, lethargy, and even coma, and there is often a drop in blood pressure. It often reminds the patient that sepsis and septic shock have occurred, which is a manifestation of critical illness.
4, the body temperature rises, the pulse rate can increase more than 120 beats / min, the pulse is weak, there is obvious tenderness and muscle tension under the xiphoid and right upper abdomen. If the gallbladder is not resected, it can often be swollen and swollen and tender gallbladder and dirty, white blood cell count is significantly increased and right shift, up to 20,000 to 40,000 / mm3, and toxic particles can appear.
5, serum bilirubin and alkaline phosphatase values increased, and often have increased GPT and r-GT values and other liver function damage.
6, blood culture often has bacterial growth.
Diagnosis
Differential diagnosis
Differential diagnosis:
Should be differentiated from other acute abdomen. Acute abdomen is a general term for acute abdominal diseases. Common acute abdomen diseases include: acute appendicitis, acute perforation of ulcer disease, acute intestinal obstruction, acute biliary infection and cholelithiasis, acute pancreatitis, abdominal trauma, urinary calculi and rupture of ectopic pregnancy. Acute abdomen is easy to shock. The onset is often rapid, and sudden severe pain occurs under the xiphoid or in the right upper abdomen, which is generally persistent. In the event of chills and relaxation, the body temperature can exceed 40 °C. Often accompanied by nausea and vomiting. Most patients have jaundice, but the depth of the jaundice may be inconsistent with the severity of the condition.
