Recognize
Fever, jaundice and RUQ pain may be incomplete in critically ill patients. Use liver tests and imaging to identify cholestasis/obstruction while simultaneously assessing organ dysfunction and sepsis severity.
gi / hepatic
Acute Cholangitis & Biliary Sepsis — Bedside Problem
Recognition, antibiotics, resuscitation and urgent biliary source control for severe cholangitis and septic shock
Act
Use balanced crystalloid, norepinephrine for persistent hypotension and standard sepsis organ support. Persistent obstruction means antibiotics alone may fail.
Escalate
Stone extraction, stent management, malignancy evaluation and definitive gallbladder/biliary management reduce recurrence.
Evidence status
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