Symptoms to Look for when you have Cholangitis
Patients with complications of untreated cholelithiasis may experience other symptoms as well, in addition to an increased risk of severe illness, or even death. These complications of gallstone disease include:
- Severe inflammation or infection of the gallbladder (cholecystitis)
- Blockage of the main bile duct with gallstones (choledocholithiasis), which can cause jaundice or/and bile duct infection (cholangitis), as well as pancreatitis Cholangitis
More than 500,000 patients undergo removal of their gallstones and gallbladders every year in the United States, making cholecystectomy one of the most commonly performed major abdominal surgical operations. In 85 to 90 percent of cholecystectomies, the operation can be performed laparoscopically, using multiple small "band-aid" incisions instead of the traditional large (and more painful) upper abdominal incision.
For the vast majority of patients with cholelithiasis, cholecystectomy effectively relieves the symptoms of gallstones. In 10 to 15 percent of patients undergoing cholecystectomy, however, persistent or new abdominal or GI symptoms may arise after gallbladder surgery. Although there are many individual causes of chronic post-cholecystectomy abdominal or GI symptoms, the presence of such symptoms following gallbladder surgery are collectively referred to as "post-cholecystectomy" syndrome (PCS) by many experts.
I routinely receive inquiries from patients who have previously undergone cholecystectomy, and who report troubling abdominal or GI symptoms following their surgery. In many cases, USMLE Cholangitis these patients have already undergone rather extensive evaluations, but without any specific findings. Understandably, such patients are troubled and frustrated, both by their chronic symptoms and the ongoing uncertainty as to the cause (or causes) of these symptoms.
The most common symptoms attributed to PCS include chronic abdominal pain, nausea, vomiting, bloating, excessive intestinal gas, and diarrhea. Fever and jaundice, which most commonly arise from complications of gallbladder surgery, are much less common, fortunately. While the precise cause, or causes, of PCS symptoms can eventually be identified in about 90 percent of patients following a thorough evaluation, even the most comprehensive work-up can fail to identify a specific ailment as the cause of symptoms in some patients. It is important to stress that there is no universal consensus on the topic of PCS among the experts, although most agree that there are multiple and diverse causes of chronic post-cholecystectomy symptoms. Thus, it can be very difficult to counsel the small minority of patients with chronic symptoms after surgery when a comprehensive work-up fails to identify specific causes for their suffering.
Because PCS is, in effect, a non-specific clinical diagnosis assigned to patients with chronic symptoms following cholecystectomy, it is critically important that an appropriate work-up be performed in all cases of chronic PCS, so that an accurate diagnosis can be identified, and appropriate treatment can be initiated. This logical clinical approach to the assessment of PCS symptoms will identify or eliminate the most common diagnoses associated with PCS in the majority of such patients, sparing them the need for further unnecessary and invasive testing Symptoms to Look for when you have Cholangitis.