Chronic cholecystitis pathophysiology: Difference between revisions
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Revision as of 18:12, 4 September 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Chronic cholecystitis Microchapters |
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Overview
Pathophysiology
Acute cholecystitis
Cholecystitis is caused by obstruction of bile duct due to impaction of gall stone[1] . Gall stone impaction leads to damage to mucosal surface of gall bladder and bile stasis. Factors which induce cholecystits are
- Lithogenic bile
- Duct obstruction
Acute inflammation is not always necessary for the development of acute cholecystitis.
Chronic Cholecystitis
There are few studies suggesting role of pancreatic biliary reflux as a co factor for the development of chronic cholecystitis. Occult pancreatic biliary reflux can be diagnosed by measuring levels of biliary amylase levels. [2]
Acute Acalculous Cholecystitis
- Gallbladder ischemia/reperfusion injury[3]
- Prolonged periods of ischemia to gall bladder leads to disruption of normal mucosal surface.
- Lipopolysaccharides are exposed leading to activation various coagulation cascades.
- Reperfusion leads to increase humoral response which leads to further damage causing cholecystitis.
- Bile Stasis[3]
- Loss of fluids, opiod drugs, positive pressure ventilation other factors cause increase in concentration of bile in the biliary tracts.
- Bile contains phosphatidyl choline, which in increased concentration can cause mucosal disruption.
Pathology
- Chornic cholecystitis
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References
- ↑ Roslyn JJ, DenBesten L, Thompson JE, Silverman BF (1980). "Roles of lithogenic bile and cystic duct occlusion in the pathogenesis of acute cholecystitis". American Journal of Surgery. 140 (1): 126–30. PMID 7396076. Retrieved 2012-08-20. Unknown parameter
|month=ignored (help) - ↑ Amr AR, Hamdy HM, Nasr MM, Hedaya MS, Hassan AM (2012). "Effect of pancreatic biliary reflux as a cofactor in cholecystitis". Journal of the Egyptian Society of Parasitology. 42 (1): 121–8. PMID 22662601. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ 3.0 3.1 "Acute acalculous cholecystitis - Surgical Treatment - NCBI Bookshelf". Retrieved 2012-08-20.