NEET trap: Charcot's triad = pain + fever + jaundice (3 features). Reynold's pentad adds confusion + hypotension (5 features = septic cholangitis). The cause is almost always choledocholithiasis — CBD stones. Treatment is biliary decompression: ERCP + sphincterotomy + stone extraction is first-line. Surgery (CBD exploration) is reserved for failed ERCP.
Ranson's 11 criteria (5 on admission + 6 at 48 hours). Cannot be calculated until 48 hours have elapsed — a key limitation. Score ≥3 = severe pancreatitis → ICU. Best single marker of severity: CRP >150 mg/L at 48 hours. CT severity index (Balthazar + necrosis score) is used for imaging-based grading. Remember: amylase and lipase levels do NOT correlate with severity.
Double-duct sign on MRCP/ERCP = simultaneous dilatation of CBD and pancreatic duct at the ampulla — highly suggestive of periampullary/pancreatic head carcinoma. Courvoisier's law: painless, palpable gallbladder + jaundice = malignant obstruction (not stones, because chronic stone disease causes fibrosis of the GB wall). 5-year survival after Whipple's: ~20–25% — best among pancreatic cancers.