A 48-year-old man presents with jaundice, right upper quadrant pain and fever. Examination shows hypotension and confusion. Labs reveal elevated bilir...

Question

A 48-year-old man presents with jaundice, right upper quadrant pain and fever. Examination shows hypotension and confusion. Labs reveal elevated bilirubin and cholestatic liver enzymes. You suspect acute ascending cholangitis. Which is the most appropriate initial management?

Accepted Answer

Admit, start broad-spectrum IV antibiotics and arrange urgent biliary decompression

Answer

Discharge with oral antibiotics and ultrasound in 1 week

Answer

Perform percutaneous liver biopsy

Answer

Treat with NSAIDs only for pain

Answer

Observe without intervention because it is usually self-limited

ca-mccqe1 MCQ (SBA): Acute ascending cholangitis

A 48-year-old man presents with jaundice, right upper quadrant pain and fever. Examination shows hypotension and confusion. Labs reveal elevated bilirubin and cholestatic liver enzymes. You suspect acute ascending cholangitis. Which is the most appropriate initial management?