sepsis with septic shock due to ascending cholangitis
AI-generated summary
Nancy Campbell, an 82-year-old woman with delusional disorder subject to mental health treatment orders, died from sepsis with septic shock due to ascending cholangitis. She had gallstones identified on MRCP during psychiatric admission but was deemed high-risk for elective cholecystectomy and discharged without symptoms. She presented acutely on 22 June 2019 with upper chest pain and lethargy, deteriorating rapidly with septicaemia despite supportive care. The coroner found her psychiatric and medical care was appropriate and her death could not have been reasonably prevented. The acute presentation of ascending cholangitis with septic shock is a rapidly progressive surgical emergency; earlier recognition of biliary risk factors or closer surveillance may have been relevant, though her acute decompensation was difficult to predict given her asymptomatic gallstone disease at discharge.
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