Cholangitis with acute renal failure: priorities in therapeutics.

Abstract:

:Obstructive cholangitis with acute renal failure is a dramatic syndrome which merits individual definition. Twenty-one patients with acute suppurative cholangitis complicated by rapidly developing renal insufficiency were studied, and the severity of the renal failure, an acute interstitial tubulopathy, bore no significant relationship to the serum bilirubin level. The mechanism of renal damage was clearly related to episodes of septicemia. Increasing experience has modified the approach to treatment. The dominant septic problem can often be controlled by vigorous antibiotic and fluid therapy, allowing time for spontaneous improvements in renal function. All patients thus operated at a distance from the septic episode survived. If emergency operation is required because of persistent or recrudescnet sepsis, the necessity for dialysis should be considered first; the circumstances demanding dialysis are defined. The priorities in therapy are then: 1) treatment of the infection, 2) treatment of the renal failure, and finally 3) operation. The amount of the operation depends on the evolution of the sepsis, but should be preceded by dialysis when required.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Bismuth H,Kuntziger H,Corlette MB

doi

10.1097/00000658-197506000-00022

subject

Has Abstract

pub_date

1975-06-01 00:00:00

pages

881-7

issue

6

eissn

0003-4932

issn

1528-1140

journal_volume

181

pub_type

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