Which triad defines cholangitis clinically?

• A. Murphy sign is pathognomonic for cholangitis.
• B. Charcot's triad: RUQ pain, jaundice, fever.
• C. Rosving sign is typical.
• D. Mallory-Weiss triad.

Answer: (B)

Cholangitis is best recognized by a classic cluster of symptoms caused by obstruction of the biliary tree with infection. Charcot's triad—right upper quadrant pain, jaundice, and fever—captures this pattern. RUQ pain comes from biliary inflammation and distention, jaundice reflects obstructive conjugated hyperbilirubinemia, and fever signals systemic infection from ascending cholangitis. In more severe cases, Reynolds pentad adds hypotension and mental status changes, indicating sepsis.

Other signs in unrelated conditions help differentiate this from other GI issues: Murphy’s sign points to acute cholecystitis, not cholangitis; Rovsing’s sign is associated with appendicitis; Mallory-Weiss refers to a mucosal tear causing GI bleeding after retching, not a biliary infection.