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charcot fail

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 transferred a guy recently who didn't read the textbook. presented as diffuse upper abd pain. wbc 21,000. lfts all 300+, T. Bili 9, lipase nl

cbd 13 mm with noted cholecysitis by CT.

no fever. no chills. no ams. no jaundice. no hypotension.

ERCP done. stone and pus in CBD. incidental chole done without complication.

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Maybe the Force was strong and wasn't that sore...yet.  I once saw classic Charcot's Triad and Reynold's Pentad=>they were floridly septic of course.  Like fishbum noted, people often showed up late in presentation...much like this person did.  Spouse didn't think there was much wrong with them/didn't believe them 🙄



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