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cholangiohepatitis

Sonopath Forum

Sonopath Forum

cholangiohepatitis

4 yr MN DSH, indoor only, acute anorexia. ALT 4700 (now 1100), T bili started at 1.8 (now 5.8). On ursodiol, GI support, eating a small amount now. Plan to perform coags and ultrasound guided parenchyma aspirate and cholecentesis for cytology and C&S (aerobic and anaerobic?). I know you recommend going through parenchyma for the centesis. Is a 22 GA typically adequate? Any other tips or recommendations? Empiric antibiotics pending C&S? He also has hx intermittent soft stools with normal appearing small bowel on US.

Comments

Remo Lobetti
April 10, 2025 at 3:39 am -

Perfect plan and either a 22 or 23G needle for the centesis. Would wait for C&S before starting antibiotics, unless there is clinical deterioration, pyrexia or an increasing inflammatory white cell response on CBC. With the soft stools also consider under lying IBD and possibly pancreatitis.

kromero
April 11, 2025 at 12:08 pm -

Thanks so much, Dr. Lobetti!

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