Chronic cholecystitis differential diagnosis: Difference between revisions
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* [[Cholangitis]] | * [[Cholangitis]] | ||
** An infection of entire biliary tract. | ** An infection of entire biliary tract. | ||
** It may involve pathogens of distal bowels and is also known as 'ascending cholangitis.<ref name="pmid1563308">{{cite journal |author=Sung JY; Costerton JW; Shaffer EA |title=Defense system in the biliary tract against bacterial infection |journal=World J. Gastroenterol. |volume=37 |issue=5 |pages=689–96 |year=1992 |pmid=1563308 |doi=10.1007/BF01296423}}</ref> | ** It may involve pathogens of distal bowels and is also known as 'ascending cholangitis.<ref name="pmid1563308">{{cite journal |author=Sung JY; Costerton JW; Shaffer EA |title=Defense system in the biliary tract against bacterial infection |journal=World J. Gastroenterol. |volume=37 |issue=5 |pages=689–96 |year=1992 |pmid=1563308 |doi=10.1007/BF01296423}}</ref> | ||
** The classical sign of cholangitis is [[Charcot's triad]] - which is right upper quadrant pain, [[fever]] and [[jaundice]] | ** 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]]. | ** [[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. | ||
Revision as of 12:53, 15 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.