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Charcot's triad - acute cholangitis

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Charcot's triad consists of fever, jaundice, and upper quadrant abdominal pain, signaling acute cholangitis due to bile duct obstruction. Chronic infection by liver flukes can cause severe hepatic complications like cirrhosis and cholangiocarcinoma. Obstructive jaundice features elevated conjugated bilirubin in the blood and urine.

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Charcot's Triad and Acute Cholangitis

Charcot's triad refers to the three clinical signs often associated with acute cholangitis: fever, jaundice, and right upper quadrant abdominal pain. Acute cholangitis is an infection of the bile ducts, which typically occurs when there is an obstruction in the bile ducts that prevents bile from flowing normally. Causes of this obstruction can include gallstones, tumors, or inflammation. Clinical presentations may include fever, malaise, anemia, and abdominal symptoms. If not promptly treated, acute cholangitis can lead to serious complications such as sepsis, organ failure, or death.

Obstructive or post-hepatic jaundice can manifest through an increase in conjugated bilirubin in the blood due to biliary tree obstruction. Patients with obstructive jaundice may also present with choluric jaundice, where the regurgitation of conjugated bile pigments into blood and urine occurs, secondary to the biliary obstruction. Diagnostic tools such as the Van Den Bergh test can be useful for assessing jaundice.

Complications of a chronic infection by parasites such as Fasciola flukes can lead to conditions like cholangitis, cirrhosis, pancreatitis, cholecystitis, and gallstones. Moreover, long-standing infections by certain species such as Clonorchis sinensis can increase the risk of developing cholangiocarcinoma, a type of bile duct cancer.

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