Acute cholecystitis natural history, complications and prognosis: Difference between revisions
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Common complications of acute cholecystitis include:<ref name="pmid13689586">{{cite journal |vauthors=BYRNE JJ, BERGER RL |title=The pathogenesis of acute cholecystitis |journal=Arch Surg |volume=81 |issue= |pages=812–6 |year=1960 |pmid=13689586 |doi= |url=}}</ref><ref name="pmid2238655">{{cite journal |vauthors=Reiss R, Nudelman I, Gutman C, Deutsch AA |title=Changing trends in surgery for acute cholecystitis |journal=World J Surg |volume=14 |issue=5 |pages=567–70; discussion 570–1 |year=1990 |pmid=2238655 |doi= |url=}}</ref><ref name="pmid3605024">{{cite journal |vauthors=Roslyn JJ, Thompson JE, Darvin H, DenBesten L |title=Risk factors for gallbladder perforation |journal=Am. J. Gastroenterol. |volume=82 |issue=7 |pages=636–40 |year=1987 |pmid=3605024 |doi= |url=}}</ref><ref name="pmid2083919">{{cite journal |vauthors=Lorenz RW, Steffen HM |title=Emphysematous cholecystitis: diagnostic problems and differential diagnosis of gallbladder gas accumulations |journal=Hepatogastroenterology |volume=37 Suppl 2 |issue= |pages=103–6 |year=1990 |pmid=2083919 |doi= |url=}}</ref><ref name="pmid2200556">{{cite journal |vauthors=Clavien PA, Richon J, Burgan S, Rohner A |title=Gallstone ileus |journal=Br J Surg |volume=77 |issue=7 |pages=737–42 |year=1990 |pmid=2200556 |doi= |url=}}</ref><ref name="pmid26311909">{{cite journal |vauthors=Chawla A, Bosco JI, Lim TC, Srinivasan S, Teh HS, Shenoy JN |title=Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting |journal=Singapore Med J |volume=56 |issue=8 |pages=438–43; quiz 444 |year=2015 |pmid=26311909 |pmc=4545132 |doi=10.11622/smedj.2015120 |url=}}</ref> | Common complications of acute cholecystitis include:<ref name="pmid13689586">{{cite journal |vauthors=BYRNE JJ, BERGER RL |title=The pathogenesis of acute cholecystitis |journal=Arch Surg |volume=81 |issue= |pages=812–6 |year=1960 |pmid=13689586 |doi= |url=}}</ref><ref name="pmid2238655">{{cite journal |vauthors=Reiss R, Nudelman I, Gutman C, Deutsch AA |title=Changing trends in surgery for acute cholecystitis |journal=World J Surg |volume=14 |issue=5 |pages=567–70; discussion 570–1 |year=1990 |pmid=2238655 |doi= |url=}}</ref><ref name="pmid3605024">{{cite journal |vauthors=Roslyn JJ, Thompson JE, Darvin H, DenBesten L |title=Risk factors for gallbladder perforation |journal=Am. J. Gastroenterol. |volume=82 |issue=7 |pages=636–40 |year=1987 |pmid=3605024 |doi= |url=}}</ref><ref name="pmid2083919">{{cite journal |vauthors=Lorenz RW, Steffen HM |title=Emphysematous cholecystitis: diagnostic problems and differential diagnosis of gallbladder gas accumulations |journal=Hepatogastroenterology |volume=37 Suppl 2 |issue= |pages=103–6 |year=1990 |pmid=2083919 |doi= |url=}}</ref><ref name="pmid2200556">{{cite journal |vauthors=Clavien PA, Richon J, Burgan S, Rohner A |title=Gallstone ileus |journal=Br J Surg |volume=77 |issue=7 |pages=737–42 |year=1990 |pmid=2200556 |doi= |url=}}</ref><ref name="pmid26311909">{{cite journal |vauthors=Chawla A, Bosco JI, Lim TC, Srinivasan S, Teh HS, Shenoy JN |title=Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting |journal=Singapore Med J |volume=56 |issue=8 |pages=438–43; quiz 444 |year=2015 |pmid=26311909 |pmc=4545132 |doi=10.11622/smedj.2015120 |url=}}</ref> | ||
====== 1. [[Gangrene]] | ====== 1. [[Gangrene]]: ====== | ||
Gangrene of Gall Bladder is the most common complication of acute cholecystitis if left untreated and in elderly patients with an underlying disease of [[diabetes]]. | Gangrene of Gall Bladder is the most common complication of acute cholecystitis if left untreated and in elderly patients with an underlying disease of [[diabetes]]. | ||
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====== 3. Cholecystoenteric fistula : ====== | ====== 3. Cholecystoenteric fistula : ====== | ||
usually occurs due to the perforation of gall bladder directly into the duodenum or jejunum. | The Cholecystoenteric fistula usually occurs due to the perforation of the gall bladder directly into the duodenum or jejunum resulting from the long standing pressure necrosis due to gall stones than acute cholecystitis. | ||
====== 4. Emphysematous cholecystitis: ====== | ====== 4. Emphysematous cholecystitis: ====== | ||
It occurs due to the secondary infection of the gall bladder wall with gas forming organisms i.e Clostridium welchii, other organisms which can be found are [[Escherichia coli]] [[Staphylococcus aureus|staphylococci]], [[Streptococcus|streptococci]], [[Pseudomonas]], and [[Klebsiella]]. | |||
====== 5. [[Gallstone ileus]]: ====== | ====== 5. [[Gallstone ileus]]: ====== | ||
Gallstone ileus may occur due to the passage of gall stone through the cholecystoenteric fistula leading to mechanical obstruction of bowel in the terminal ileum. | |||
===Prognosis=== | ===Prognosis=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- The symptoms of (disease name) usually develop in the first/ second/ third decade of life, and start with symptoms such as ___.
- The symptoms of (disease name) typically develop ___ years after exposure to ___.
- If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Complications
Common complications of acute cholecystitis include:[1][2][3][4][5][6]
1. Gangrene:
Gangrene of Gall Bladder is the most common complication of acute cholecystitis if left untreated and in elderly patients with an underlying disease of diabetes.
2. Perforation:
Perforation of Gall Bladder results due to the gangrene of the gall bladder and leads to pericholecystic abscess. Peritonitis may also occur as a result of gall bladder perforation these patients develop septicemia and have a high mortality rate.
3. Cholecystoenteric fistula :
The Cholecystoenteric fistula usually occurs due to the perforation of the gall bladder directly into the duodenum or jejunum resulting from the long standing pressure necrosis due to gall stones than acute cholecystitis.
4. Emphysematous cholecystitis:
It occurs due to the secondary infection of the gall bladder wall with gas forming organisms i.e Clostridium welchii, other organisms which can be found are Escherichia coli staphylococci, streptococci, Pseudomonas, and Klebsiella.
5. Gallstone ileus:
Gallstone ileus may occur due to the passage of gall stone through the cholecystoenteric fistula leading to mechanical obstruction of bowel in the terminal ileum.
Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
References
- ↑ BYRNE JJ, BERGER RL (1960). "The pathogenesis of acute cholecystitis". Arch Surg. 81: 812–6. PMID 13689586.
- ↑ Reiss R, Nudelman I, Gutman C, Deutsch AA (1990). "Changing trends in surgery for acute cholecystitis". World J Surg. 14 (5): 567–70, discussion 570–1. PMID 2238655.
- ↑ Roslyn JJ, Thompson JE, Darvin H, DenBesten L (1987). "Risk factors for gallbladder perforation". Am. J. Gastroenterol. 82 (7): 636–40. PMID 3605024.
- ↑ Lorenz RW, Steffen HM (1990). "Emphysematous cholecystitis: diagnostic problems and differential diagnosis of gallbladder gas accumulations". Hepatogastroenterology. 37 Suppl 2: 103–6. PMID 2083919.
- ↑ Clavien PA, Richon J, Burgan S, Rohner A (1990). "Gallstone ileus". Br J Surg. 77 (7): 737–42. PMID 2200556.
- ↑ Chawla A, Bosco JI, Lim TC, Srinivasan S, Teh HS, Shenoy JN (2015). "Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting". Singapore Med J. 56 (8): 438–43, quiz 444. doi:10.11622/smedj.2015120. PMC 4545132. PMID 26311909.