+Lorenzo Crumbie if you have complete obstruction of the common bile duct, there would be a clinical picture consistent with choledocholithiasis. not unless there is some degree of patency in the bile duct can pathogens "ascend" and cause infection
+Lorenzo Crumbie reynolds pentad is just a severe condition of cholangitis .obstructive is the main cause which result in cholangitis if its not treated immeditely pts may progress from charcot to reynolds symptoms.....if im wrong pls crt me....
i got stuck on this too. You are right -- the things I've found say choledocholiathisis increases risk of ascending cholangitis / acute ascending cholangitis. Ascending Cholangitis = Charcots triad of RUQ pain + Fever + Jaundice Acute Ascending Cholangitis = Reynolds Pentad which is [Charcots triad] + hypotension/shock and altered mental status
@ 12:33 you say this isn't an obstruction, you then state that 75% of cases have an obstuction, then @ 18:57 you show a stone obstucting the cystic duct. Clearification needed.
Hi - I have a question about cholecystectomy for patients with acute cholecystitis. I think current NICE guidance recently changed so that anyone with acute cholecystitis is offered a laparoscopic cholecystectomy within one week. Have you noticed a change over the past few years towards favouring early surgery rather than waiting for resolution of symptoms?
When i were on syed ali wasif treatment so muslims from their cars used to show me light to blink my eyes, like aafiya siddiqua, so stop letting that to happen with me
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Reynold's Pentad for Obstructive Ascending Cholangitis:
1) Right Upper Quadrant Pain,
2) Obstructive jaundice
3) Fever
4) Hypotension / Hypovolemic Shock
5) Confusion / Altered mental status
I think B HCG is more important because the pt may have ectopic pregnancy in case of RUQ pain ,
thank you so much for your help.
dude!! u are literally saving my life.
Charcot's triad (RUQ pain, jaundice and fever..and it is for ascending cholangitis); Reynolds' pentad (RUQ pain, jaundice, fever, hypotension[shock] and confusion[altered mental status]) diagnosing obstructive ascending cholangitis.
+Lorenzo Crumbie if you have complete obstruction of the common bile duct, there would be a clinical picture consistent with choledocholithiasis. not unless there is some degree of patency in the bile duct can pathogens "ascend" and cause infection
+Lorenzo Crumbie reynolds pentad is just a severe condition of cholangitis .obstructive is the main cause which result in cholangitis if its not treated immeditely pts may progress from charcot to reynolds symptoms.....if im wrong pls crt me....
Thanks for integrating multiple ultrasound images into this!
Thank you keep doing the good work.
The best video on RUclips about this topic 😇
Isn't Charcot's trial (RUQ pain, jaundice, and fever) already a sign of ascending cholangitis?
Shouldn't fever be absent in choledochocholithiasis?
yep, it is
i got stuck on this too.
You are right -- the things I've found say choledocholiathisis increases risk of ascending cholangitis / acute ascending cholangitis.
Ascending Cholangitis = Charcots triad of RUQ pain + Fever + Jaundice
Acute Ascending Cholangitis = Reynolds Pentad which is [Charcots triad] + hypotension/shock and altered mental status
sounds right, i was a lil confused too
Charcot's triad:
1) Severe Right Upper Quadrant Pain
2) Obstructive / Mechanical Jaundice
3) High Swinging Fever
For Ascending Cholangitis
@@DrDinooshDeLivera Had it on a test yesterday and mixed it up :,-(
it's charcot's triad ....the one you forgot
@ 12:33 you say this isn't an obstruction, you then state that 75% of cases have an obstuction, then @ 18:57 you show a stone obstucting the cystic duct. Clearification needed.
hepatobiliary iminodiacetic acid (HIDA)
Hi - I have a question about cholecystectomy for patients with acute cholecystitis. I think current NICE guidance recently changed so that anyone with acute cholecystitis is offered a laparoscopic cholecystectomy within one week. Have you noticed a change over the past few years towards favouring early surgery rather than waiting for resolution of symptoms?
Thank you soooo much doctor Paul ❤
Fantastic lecture. Cheers
Amazing lecture, thanks doctor
Excellent.
Thank you.
💯🚀🙌precise explanation!
what do you mean when you step 3 ? is it surgical residency or internship ?
thank you!
Is it charcoats triad u were talking about Dr
Is it possible to access these slides?
thank you
sorry u r right mattia...ascending cholangitis or acute cholangitis r same
Thank sir
1. charcot tirad
2, reyonald pentade
its a sign of acute cholangitis not ascending ..I think..
woah that actually alll made way more sense .,,, thank you
Jesus! Saved me!
When i were on syed ali wasif treatment so muslims from their cars used to show me light to blink my eyes, like aafiya siddiqua, so stop letting that to happen with me
Thank you.
Thank you!