A case of Extrahepatic Biliary Tract Obstruction with CBD Stone, Septic Shock & Cholangitis

Dr. Hardik Ahuja is sharing a case of Extrahepatic Biliary Tract Obstruction with CBD Stone, Septic Shock & Cholangitis managed with great expertise by him. Share your views on the case & learn new things Follow us for more such updates!

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Congratulations Doctor Dr @Hardik Ahuja sir In the examination part even though the BP is 86/40 there is no peripheral edema., Charcots triad observed suggesting Cholangitis., Increased Ast, Alt suggests Hepatitis And ALP suggests Blockade in the bile duct., Amazingly treated Doctor!

Thankyou doctor
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उत्तम

Good case👌 Is CBD stone extracted??? Or Just only stenting done

Thankyou doctor
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Informative

Amazing case presentation

Nice case

Good presentation frd.

Excellent management Dr Ahuja Sir . Congrats Sir . But I have small post script to add . The recorded BP iof 86/40 mm Hg s suggestive of septic Shock , as indicated by the MAP ( mean arterial pressure ) . Any thing below of 60 mm Hg of MAP is shock and the very low diastolic pressure , Indicative of peripheral arterial dilation and putting both to gather it qualifies for septic shock . In fact ,the MAP in this case is 55mmHg (MAP = SYSTOLLLIC BP + 2(DIASTOLIC BP) ÷ 3 = 166÷3 = 55 (rounded off) This is far less than the lower limit to qualify for shock . The goal of treatment besides antibiotics is to keep MAP at at 65 mmHg with pressure agents and uids , to maintain tissue perfusion to vital organs like brain, heart and kidneys etc . Also is required is monitoring of blood Lactate level which should be kept below 2 meq /lt . As such , an experienced physician's services should have been recruited . Atleast in the whole presentation there is no mention.of a word about the septic shock ! "All is well that ends well " ! Fine if not ? The pt is in risk of MODF !

Thank you Dr Ram Singh .
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Congratulations Dr ☺️

Nice Sir ji

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