Reynolds' pentad

Reynolds' pentad is a collection of signs and symptoms suggesting the diagnosis of ascending cholangitis, an infection of the bile duct, usually caused by bacteria ascending from its junction with the duodenum. It consists of the four components of Charcot's triad plus shock and mental confusion.

Signs and Symptoms

Reynolds' pentad includes the following signs and symptoms:

• Jaundice: This is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae, and other mucous membranes caused by high blood bilirubin levels.
• Fever and chills: These are common symptoms of infection and inflammation.
• Right upper quadrant (abdominal) pain: This is due to inflammation or distension of the liver and gallbladder.
• Septic shock: This is a serious condition that occurs when an infection leads to life-threatening low blood pressure.
• Mental confusion: This can be a result of septic shock or the overall systemic response to infection.

Causes

The most common cause of Reynolds' pentad is ascending cholangitis, which is typically caused by a bacterial infection. The bacteria often ascend from the junction of the bile duct and the duodenum.

Diagnosis

The diagnosis of Reynolds' pentad is primarily clinical, based on the presence of the five signs and symptoms. Additional tests such as blood tests, imaging studies like ultrasound or CT scan, and sometimes ERCP (endoscopic retrograde cholangiopancreatography) may be used to confirm the diagnosis and identify the underlying cause.

Treatment

Treatment of Reynolds' pentad involves addressing the underlying cause, which is typically ascending cholangitis. This usually involves antibiotics to treat the infection, and sometimes procedures to relieve obstruction in the bile duct, if present.

See Also

• Charcot's triad
• Ascending cholangitis
• Septic shock

Reynolds' pentad Resources
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