Acute ascending cholangitis.

Pancreatic cancer is a devastating disease often associated with other comorbid conditions that can complicate treatment and impact quality of life. Obstruction of the bile duct by pancreatic cancer can cause bile stasis and infection, a condition known as acute ascending cholangitis (AAC). Signs and symptoms include fever, pain, and increased serum bilirubin levels. Serious complications (e.g., sepsis, death) may be avoided with careful and timely patient assessment, prompt initiation of antibiotics, and drainage of the biliary system. AAC may present quickly, and patients can deteriorate rapidly. Nurses need to be aware of the clinical manifestations of AAC to ensure timely treatment of this sometimes fatal event.