Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.

Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.

Cholecystitis is a relatively common disease with a high incidence. As name suggests, cholecystitis is an inflammation of gallbladder that can be acute or chronic. Cholecystitis often coexists with gallstone disease. A typical site of pain is severe pain or colic in right hypochondrium, which is more common with calculi or parasitic inlays. In acute cholecystitis caused by obstruction of gallbladder neck, pain often comes on suddenly, is very severe, or has a colicky appearance. In addition, with non-obstructive acute cholecystitis of cystic duct, pain in right hypochondrium, as a rule, is not pronounced, is predominantly persistent, with progression of inflammation of gallbladder, pain can also increase, and pain "radiates" localization to right shoulder and lower angle of right scapula.

Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.
cause

The most common cause of cholecystitis is gallstones (90% of cases). Bile is collected in the gallbladder. This causes irritation and can be a major cause of inflammation (chemical inflammation). This causes infection, usually as a result of colonization by intestinal organisms. Gallstones (cholecystitis) are not affected in 10% of cases.

Risk factors for calculous cholecystitis
  • Gallstones are more common in women.
  • Aging
  • Obesity or rapid weight loss
  • Pregnancy
  • Drugs
  • Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.

    Acalculous cholecystitis is associated with cholestasis, including malnutrition, major surgery, major trauma, sepsis, long-term total parenteral nutrition (TPN), and prolonged fasting. Other causes of non-invasive cholecystitis include heart attacks, sickle cell anemia, salmonella infection, diabetes, arrhythmia.

    Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.
symptom

    Cholecystitis is often accompanied by gallstones. A patient with classic cholecystitis was described as "obese, 40 years old, female, fertile". The main symptom is abdominal pain in right hypochondrium (right hypochondrium). Fever (infection), nausea, and vomiting may also occur.

    The main clinical sign is hypochondriacal pain on right.

    Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.
diagnosis
  • Abdominal ultrasonography has high sensitivity and specificity in diagnosis of gallstones and cholecystitis. Signs suggestive of acute cholecystitis include perivesical fluid, thickening of gallbladder wall, and presence of gallstones.
  • Computed tomography of abdomen can also detect acute cholecystitis with a sensitivity of more than 95%. An MRI scan has a similar accuracy.
  • The HIDA scan is best way to diagnose acute cholecystitis.
  • ERCP may be useful in patients at high risk of choledocholithiasis if there are signs of choledocholithiasis. It has therapeutic and diagnostic benefits.
  • Other tests include: abdominal x-ray, oral cholecystography. A complete blood count shows an increased number of white blood cells during an infection. All women of childbearing age should take a pregnancy test.
  • Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.
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    The initial treatment for acute cholecystitis usually consists of antibiotics (ampicillin, ampicillin/sulbactam, or piperacillin/tazobactam). In severe life-threatening cases, primaxin or meropenem (Primaxin or meropenem) and adjuvant therapy (eg, painkillers) are prescribed, followed by surgical removal of gallbladder - cholecystectomy. Cholecystectomy can be performed as either a laparotomy or a laparoscopic procedure, but there is an established trend towards laparoscopic surgery, which has advantage of a shorter postoperative recovery period and less surgical scarring.

    Acute/chronic cholecystitis, typical symptoms are pain in upper right abdomen, pain radiating to right shoulder.

    Patients with cholecystitis who are hospitalized for a proposed operation should not receive any oral (OGO) drugs. However, for uncomplicated cholecystitis, a liquid or low-fat diet may be appropriate before surgery.