Reynolds pentad

A set of clinical signs indicating severe acute ascending cholangitis with systemic inflammatory response, sepsis, and possible organ dysfunction:

• Charcot triad:

  • Fever

  • Right upper quadrant abdominal pain

  • Jaundice

• Hypotension

• Altered mental status

Causes of ascending cholangitis

• Biliary obstruction

  • Choledocholithiasis

  • Benign biliary stricture: Primary sclerosing cholangitis

  • Post-surgical or iatrogenic biliary obstruction

• Malignant causes

  • Cholangiocarcinoma

  • Pancreatic cancer

  • Other periampullary tumors

• Liver fluke infection (Clonorchis sinensis, Opisthorchis species)

• Biliary instrumentation (ERCP, stent placement)