Characterization of Abdominal Pain in Cholangitis

Clinical Presentation

• Abdominal tenderness in the right upper quadrant is a typical finding in patients with cholangitis, as revealed by physical examination 1
• The pain of cholangitis can be distinguished from acute cholecystitis by the presence of jaundice, indicating biliary obstruction, and the absence of Murphy's sign, with right upper quadrant pain and fever being common to both conditions 1, 2

Diagnostic Evaluation

• Initial imaging with ultrasound is recommended to assess for biliary dilatation and obstruction in patients suspected of having cholangitis 1, 2
• Advanced imaging with MRCP may be necessary for detailed visualization of intra- and extra-hepatic bile duct dilatation when the diagnosis is unclear 1, 2