Table 1.
Diagnostic criteria for acute cholangitis
| (A) Original | |
| A. Clinical signs | 1. Fever and/or chills |
| 2. Jaundice | |
| 3. Abd. pain (RUQ, epigastric) | |
| B. Laboratory data | 4. Leukocytosis or elevation of CRP level |
| 5. Elevation of ALP or γ-GTP level | |
| C. Imaging findings | 6. Biliary dilatation or etiology (stricture, tumor, stones) |
| Definite diagnosis | (1) All items in A (Charcot’s triad) |
| (2) One or two items in A + all items in B + C | |
| Note: acute hepatitis and other causes of acute abdomen should be excluded | |
| (B) Proposed revision 1 at International Meeting | |
| A. Clinical context and manifestations | 1. History of biliary disease |
| 2. Fever and/or chills | |
| 3. Jaundice | |
| 4. Abd. pain (RUQ, epigastric) | |
| B. Laboratory data | 5. Abnormal WBC count |
| 6. Elevation of CRP level or other evidence of inflammatory response | |
| 7. Abnormal liver function tests (ALP, γ-GTP, AST, ALT) | |
| C. Imaging findings | 8. Biliary dilatation, inflammatory findings, or etiology (stricture, tumor, stones) |
| Definite diagnosis | (1) Three or 4 items in A (Charcot’s triad) |
| (2) Any item in A + 2 items in B + C | |
| Note: acute hepatitis and other causes of acute abdomen should be excluded | |
| (C) Proposed revision 2 at International Meeting | |
| A. Clinical context and manifestations | 1. Fever and/or chills |
| 2. Jaundice | |
| 3. Abd. pain (RUQ, epigastric) | |
| B. Laboratory data | 4. Abnormal WBC count |
| 5. Elevation of CRP level or other evidence of inflammatory response | |
| 6. Abnormal liver function tests (ALP, γ-GTP, AST, ALT) | |
| C. Imaging findings | 7. Biliary dilatation, inflammatory findings, or etiology (stricture, tumor, stones) |
| Definite diagnosis | (1) Any item in A + 2 items in B + C |
| Note: acute hepatitis and other causes of acute abdomen should be excluded | |
| (D) Final version of diagnostic criteria for acute cholangitis | |
| A. Clinical context and clinical manifestations | 1. History of biliary disease |
| 2. Fever and/or chills | |
| 3. Jaundice | |
| 4. Abdominal pain (RUQ or upper abdominal) | |
| B. Laboratory data | 5. Evidence of inflammatory responsea |
| 6. Abnormal liver function testsb | |
| C. Imaging findings | 7. Biliary dilatation, or evidence of an etiology (stricture, stone, stent, etc) |
| Suspected diagnosis | Two or more items in A |
| Definite diagnosis | (1) Charcot’s triad (2 + 3 + 4) |
| (2) Two or more items in A + both items in B + C | |
a Abnormal WBC count, increased serum CRP level, and other changes indicating inflammation
b Increased serum ALP, γ-GTP (GGT), AST, and ALT levels