A 55-year-old male presents with severe right upper quadrant pain, fever (39.5°C), and jaundice (Charcot's triad). His blood pressure is 85/55 mmHg an...

Question

A 55-year-old male presents with severe right upper quadrant pain, fever (39.5°C), and jaundice (Charcot's triad). His blood pressure is 85/55 mmHg and he is confused. What is the diagnosis when hypotension and confusion are added to Charcot's triad?

Accepted Answer

Reynolds' pentad - ascending cholangitis with septic shock (Charcot's triad plus hypotension and altered mental status); this carries a very high mortality without urgent biliary drainage

Answer

Pancreatitis with secondary infection

Answer

Acute cholecystitis with gallbladder perforation

Answer

Charcot's triad alone - the additional features are coincidental

Answer

Hepatic abscess without biliary involvement

uk-dipimc MCQ (SBA): Reynolds' Pentad

A 55-year-old male presents with severe right upper quadrant pain, fever (39.5°C), and jaundice (Charcot's triad). His blood pressure is 85/55 mmHg and he is confused. What is the diagnosis when hypotension and confusion are added to Charcot's triad?