Chronic cholecystitis differential diagnosis: Difference between revisions
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** [[Liver function tests]] - increase if enzymes ([[AST]], [[ALT]], [[ALP]], [[GGT]]) with raised [[bilirubin]]. | ** [[Liver function tests]] - increase if enzymes ([[AST]], [[ALT]], [[ALP]], [[GGT]]) with raised [[bilirubin]]. | ||
** [[Bile]] is an extremely favorable [[growth medium]] for bacteria and infections develop rapidly and become quite severe. | ** [[Bile]] is an extremely favorable [[growth medium]] for bacteria and infections develop rapidly and become quite severe. | ||
===Acute cholecystitis=== | |||
*This should be suspected whenever there is acute [[right upper quadrant]] or [[epigastric pain]]. | |||
**Other possible causes include: | |||
***[[Perforated peptic ulcer]] | |||
***[[Acute peptic ulcer exacerbation]] | |||
***[[Amoebic liver abscess]] | |||
***[[Acute pancreatitis]] | |||
***[[Acute intestinal obstruction]] | |||
***[[Renal colic]] | |||
***[[Acute retrocolic appendicitis]] | |||
***[[MI]] | |||
===Chronic cholecystitis=== | |||
*The symptoms of chronic cholecystitis are non-specific, thus chronic cholecystitis may be mistaken for other common disorders: | |||
**[[Peptic ulcer]] | |||
**[[Hiatus hernia]] | |||
**[[Colitis]] | |||
**Functional bowel syndrome | |||
==References== | ==References== | ||
Revision as of 23:51, 2 February 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Differentiating Cholecystitis from other Diseases
- Biliary colic
- Caused by obstruction of the cystic duct
- Sharp and constant epigastric pain without fever
- Murphy's sign is negative
- Liver function tests are normal
- Choledocholithiasis
- Blockage of the common bile duct
- Associated with 'colicky' pain
- Obstructive jaundice
- Liver function tests - increase in serum bilirubin, high conjugated bilirubin, raised GGT and ALP
- Cholangitis
- An infection of entire biliary tract.
- It may involve pathogens of distal bowels and is also known as 'ascending cholangitis.[1].
- The classical sign of cholangitis is Charcot's triad - which is right upper quadrant pain, fever and jaundice.
- Liver function tests - increase if enzymes (AST, ALT, ALP, GGT) with raised bilirubin.
- Bile is an extremely favorable growth medium for bacteria and infections develop rapidly and become quite severe.
Acute cholecystitis
- This should be suspected whenever there is acute right upper quadrant or epigastric pain.
Chronic cholecystitis
- The symptoms of chronic cholecystitis are non-specific, thus chronic cholecystitis may be mistaken for other common disorders:
- Peptic ulcer
- Hiatus hernia
- Colitis
- Functional bowel syndrome
References
- ↑ Sung JY; Costerton JW; Shaffer EA (1992). "Defense system in the biliary tract against bacterial infection". World J. Gastroenterol. 37 (5): 689–96. doi:10.1007/BF01296423. PMID 1563308.