Cholecystitis resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Cholecystitis
Definitions
| Terms | Definitions |
|---|---|
| Cholecystitis | Cholecystitis is an inflammatory disease of the gallbladder. |
| Acute cholecystitis | Acute cholecystitis is an acute inflammatory disease of the gallbladder, most often attributable to gallstones.[1][2] |
| Acute calculous cholecystitis | Acute calculous cholecystitis is an acute inflammatory disease of the gallbladder in the presence of cholelithiasis.[1] |
| Acute acalculous cholecystitis | Acute acalculous cholecystitis is an acute necroinflammatory disease of the gallbladder in the absence of cholelithiasis and has a multifactorial pathogenesis.[3] |
| Chronic cholecystitis | Chronic cholecystitis is a chronic inflammatory disease of the gallbladder with histological evidence of chronic inflammation like large range of related inflammatory epithelial changes including mononuclear infiltrate, fibrosis, thickening of muscular layer, dysplasia, hyperplasia and metaplasia.[4] |
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Management
References
- ↑ 1.0 1.1 Strasberg, SM. (2008). "Clinical practice. Acute calculous cholecystitis". N Engl J Med. 358 (26): 2804–11. doi:10.1056/NEJMcp0800929. PMID 18579815. Unknown parameter
|month=ignored (help) - ↑ Reiss, R.; Deutsch, AA. (1993). "State of the art in the diagnosis and management of acute cholecystitis". Dig Dis. 11 (1): 55–64. PMID 8443956.
- ↑ Huffman, JL.; Schenker, S. (2010). "Acute acalculous cholecystitis: a review". Clin Gastroenterol Hepatol. 8 (1): 15–22. doi:10.1016/j.cgh.2009.08.034. PMID 19747982. Unknown parameter
|month=ignored (help) - ↑ Zhou, D.; Guan, WB.; Wang, JD.; Zhang, Y.; Gong, W.; Quan, ZW. (2013). "A comparative study of clinicopathological features between chronic cholecystitis patients with and without Helicobacter pylori infection in gallbladder mucosa". PLoS One. 8 (7): e70265. doi:10.1371/journal.pone.0070265. PMID 23936177.
Characterize the symptoms ❑ Abdominal pain | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
❑ Acute biliary type abdominal pain
❑ Sx suggestive of sepsis ❑ Sx suggestive of Mirizzi syndrome ❑ Sx suggestive of gallstone ileus | ❑ Acute vague abdominal pain ❑ RUQ mass ❑ Jaundice | ❑ Recurrent biliary type abdominal pain ❑ Recurrent abdominal bloating ❑ Unstable stool with constipation/diarrhea | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Examine the patient: ❑ Febrile ❑ Tachycardia ❑ Dehydrated ❑ Abdominal guarding ❑ Murphy's sign ❑ Abdominal creps ❑ Abdominal tenderness ❑ Reduced bowel sounds ❑ Increased bowel sounds ❑ Abdominal distension ❑ Signs of sepsis | Consider Dx of acute acalculous cholecystitis | Consider Dx of chronic cholecystitis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Order laboratory tests: ❑ CBC ❑ BMP ❑ Total bilirubin ❑ Direct bilirubin ❑ Albumin ❑ AST ❑ ALT ❑ Alkaline phosphatase ❑ GGT ❑ Amylase ❑ Lipase | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||