Cholelithiasis ‘Acute choleysi ‘Acute chovansiis Presence ot 4+ Prosonce of gallstones in the + Acute inflammation ofthe Description salltones inthe “+ Bactrial infection ofthe Bilary tact sgalbadser salllacder common bile duct “+ Bile cholestoroleversaturation, ble CChollthiais > + Cholelithiais (most 1+ Cholecochotithiasis (most common) > stasis, impaired bile ocd circulation > riration of common) er bilary sidge obstruction and stasis within the Mechanism, aa ae i precipitation o galstonos in the salzones into the > inflammation of bilsry tract > subzequent aocerial sgalbladser common bile duct salelacéer wall infection 1+ Charcot trad: RUG cain ever, + Unsay symptomatic + RUQpi0 indice ae Syme (noc BU ie ne Fi fits eke an symptomatic (biliary colic: RUQ pain mee sain over Reynold pentad: Charcot cholangitis «6h + Murphy sign triad PLUS hypotension and mental status changes 1 Total birubin + PWEC ang.cRP roct + raw Laboratory Normal +n wec,caP ‘incings ale + nAST ALT vast aur etal tin US: datas + Us:gallader wat common bile duct, thickening and/or edema Intrahepatic blary ‘+ US:bilary allaton, and/or evidence of (@oute wall sig Diagnostic | + US: galstones wth posteroracoustic ditaton leaeesicie cee obstruction eg, choleitnsi, aging shadow MRCP or ERCP: pericholecystic inflammation ‘of palladdar » 4 hours ‘ing dtectin the oe ‘+ MRCPit agnosis uncertain contratt-enhanced ve adminstration uct Supportive car, 4+ Supportive care analgesics analgesics 4+ Supportive cae analgesics “+ Blective cholecystectomy for: Endoscopic stone | + Supportive care analgesics | +“ Wantibotes © Symptomatic choles: reteeval + Wwantciovee “+ Urgent oifary decompression ‘Treatment nem een Bilary decom (© Asymptomatic cholelithiasis ony it lective + Cholecystectomy ting 4 Interal cholecystectomy if gastones at increased sk of galbladser cholecystectomy taprevent depends on severity) ae present or concurtent cholecystitis