Download PDF
Homœopathic Links
DOI: 10.1055/s-0040-1713879
Case Report

Homoeopathic Management of Acute Cholangitis in a Case of Adenocarcinoma of Gall Bladder with Metastasis: A Case Report

Lalith Singh
1   National Institute of Homoeopathy, Government of India, Salt Lake, Kolkata, West Bengal, India
,
Seetha Lakshmi
2   Department of Organon of Medicine, National Institute of Homoeopathy, Govt. of India, Kolkata, West Bengal, India
,
Sanjoy Kumar Das
3   National Institute of Homoeopathy, Peerless Hospital, Girish Park, Kolkata, West Bengal, India
› Author Affiliations Funding None.
› Further Information
    Permissions and Reprints

Abstract

Acute cholangitis is a bacterial infection superimposed on an obstruction of biliary tree from a gall stone, neoplasm or stricture. The biliary obstruction is most commonly caused by choledocholithiasis benign or malignant stricture of the bile duct or hepatic ducts, pancreatic cancer, ampullary adenoma or cancer, porta hepatis tumour or metastasis, biliary stent obstruction (due to microbial biofilm formation, biliary sludge deposition and duodenal reflux of food content), primary sclerosing cholangitis and amyloid deposition in the biliary system. Classically, patients present with high fever persisting for more than 24 hours, abdominal pain and jaundice (Charcot's triad). The right upper quadrant abdominal (RUQ) pain is generally mild. When the cholangitis becomes more severe, patients become hypotensive and confused (Reynold's pentad). Charcot's triad has low sensitivity (26.4%) and high specificity (95.9%). Although the presence of Charcot's triad is suggestive of acute cholangitis, it is not diagnostic. Charcot's triad is present in 26.4 to 72% of patients with acute cholangitis. TG07 diagnostic criteria for acute cholangitis also do not have enough sensitivity and specificity and its severity criteria are also not suitable for clinical use. Antibiotics, intravenous fluid, Vitamin K supplementation and biliary drainage are the options available in conventional mode of treatment for acute cholangitis. Presented here is one case report of acute cholangitis in a patient of adenocarcinoma of gall bladder with metastasis. The case was treated using classical method of homoeopathy with complete improvement in clinical and laboratory parameters of acute cholangitis.

Keywords

cholangitis - homoeopathy - adenocarcinoma - gall bladder - metastasis


Publication History

Article published online:
02 September 2024

© 2024. Thieme. All rights reserved.

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Mohammad Alizadeh AH. Cholangitis: diagnosis, treatment and prognosis. J Clin Transl Hepatol 2017; 5 (04) 404-413
    CrossrefPubMedGoogle Scholar
  • 2 Ahmed M. Acute cholangitis - an update. World J Gastrointest Pathophysiol 2018; 9 (01) 1-7
    CrossrefPubMedGoogle Scholar
  • 3 Sundaram S, Jearth V. Primary sclerosing cholangitis: a clinical update. Eur Med J 2019; 4 (03) 101-110
    CrossrefPubMedGoogle Scholar
  • 4 Mosler P. Diagnosis and management of acute cholangitis. Curr Gastroenterol Rep 2011; 13 (02) 166-172
    CrossrefPubMedGoogle Scholar
  • 5 Ungur M, Babes PA, Maghiar A, Pop GM, Feder B. Diagnosis and Therapeutic Management in Postcholecistectomy Alithiasic Cholangitis. Maedica (Bucur) 2019; 14 (03) 247-253
    PubMedGoogle Scholar
  • 6 The Bethesda Handbook of Clinical Oncology. 3rd edition. New Delhi: Wolters Kluwer (India) Pvt. Ltd; 2010
    Google Scholar
  • 7 Boey JH, Way LW. Acute cholangitis. Ann Surg 1980; 191 (03) 264-270
    CrossrefPubMedGoogle Scholar
  • 8 Allen HC. Keynotes and Characteristics with Comparisons of Some of the Leading Remedies of the Materia Medica with Bowel Nosodes. 8th edition. New Delhi: B. Jain Publishers; 2011
    Google Scholar
  • 9 Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory Reprinted. New Delhi: B. Jain Publishers; 2006
    Google Scholar