ROSH Gastrointestinal Practice Exam

What primary treatment is indicated for a patient with confirmed diagnosis of cholangitis?

1. Antibiotics

2. Endoscopy

3. Surgery

4. Observation

The correct answer is: Antibiotics

In the case of a patient with a confirmed diagnosis of cholangitis, the primary treatment indicated is antibiotics. Cholangitis is an infection of the bile duct system, often stemming from obstruction due to stones or tumors. The presence of infection necessitates the prompt administration of broad-spectrum intravenous antibiotics to control the bacterial growth and prevent serious complications like sepsis. While endoscopy may be utilized for procedures such as stone extraction or stenting in certain situations, its role is secondary to initiating antibiotic therapy. Surgery may be considered in cases where there is a need to relieve an obstruction or in severe complications, but the immediate need addresses the infection. Observation alone is insufficient in the setting of cholangitis, as it can lead to rapid clinical deterioration due to the infectious nature of the condition. Thus, antibiotic treatment is paramount in managing cholangitis effectively.