Acute and Chronic Cholecystitis

Question 1

Cholecystitis epid?

Answer 1

most commonly seen in women over the age of 40

Question 2

Acute Cholecystitis causes?

Answer 2

Usually of infectious origin (CMV, Cryptococcus);

trauma or burns;

postoperative state

Question 3

Chronic Cholecystitis causes?

Answer 3

Frequent complication of gallstones (most common cause of cholecystitis);

repeated
bouts of acute cholecystitis

Question 4

Acute Cholecystitis gross fx?

Answer 4

enlarged and discolored gallbladder;

may see obstructing stone at neck;

cloudy or
purulent bile in lumen

Question 5

Acute Cholecystitis histo fx?

Answer 5

thickened and edematous wall;

inflammatory infiltrate with vascular congestion.

Question 6

Chronic Cholecystitis gross fx?

Answer 6

thickening of gallbladder wall as a result of extensive fibrosis

Question 7

Chronic Cholecystitis histo fx?

Answer 7

subepithelial fibrosis with mononuclear infiltrate;

outpouching of mucosal epithelium through wall (Rokitansky-Aschoff sinuses)

Question 8

Acute Cholecystitis clinical signs?

Answer 8

Nausea; 
vomiting; 
fever; 
RUQ pain upon palpation; 
Murphy sign (inspiratory arrest on
RUQ palpation).

Question 9

Chronic Cholecystitis clinical signs?

Answer 9

Nausea;
vomiting;
recurrent episodes of colicky RUQ pain; intolerance to fatty foods

Question 10

Cholecystitis complications?

Answer 10

bacterial superinfection and gallbladder perforation or obstruction

Question 11

Cholecystitis treatment?

Answer 11

Antibiotics; cholecystectomy

Question 12

Acute Cholecystitis Lab findings?

Answer 12

increased ALP;

leukocytosis;

mild hyperbilirubinemia