Acute Cholecystitis Flashcards
define acute cholecystitis
inflammation of gall bladder
how many types are there?
name both types?
2
o Calculous cholecystitis
o Acalculous cholecystitis
which is the most common type of cholecystitis?
how common is it % wise?
explain pathophysiology behind this type.
Calculous cholecystitis
90%
gallstone stuck in neck of gallbladder or cystic duct –> cholestasis –> gall bladder get inflamed + bacterial overgrowth
what is the most common cause for acute cholecystitis?
gallbladder stones
why is there no jaundice with acute cholecystitis?
common bile duct open.
if stone moves to common bile duct from neck or cystic duct,
what complication can now happen?
Ascending cholangitis
what is gallbladder empyema?
what can this complicate to?
what is treatment for this complication?
gallbladder fills with pus
gallbladder perforates
urgent cholecystectomy
1st line Ix for acute cholecystitis?
US
LFTs on acute cholecystitis??
normal
FBC on acute cholecystitis?
leukocytosis with neutrophilia
what is the classical sign for acute cholecystitis?
describe this sign?
Murphy’s sign
Severe pain on inspiration when palpating RUQ
is there fever?
yes
is there diarrhoea?
no
what is the pain like in acute cholecystitis?
- location
- radiation
- character
- severity
RUQ
radiate to shoulder
like biliary colic (crampy)
severe
signs on examination?
-2
Murphy’s sign
Gallbladder distention
1st line Mx?
-2 things
IV antibiotics & cholecystectomy within 1 week
define acute cholecystitis?
vs
define ascending cholangitis?
inflammation of gall bladder
Ascending Cholangitis = bacterial infection of biliary tree
person has gallstone in neck of gallbladder causing acute cholecystitis.
but then gallstone moves into CBD, what complication can happen now?
ascending cholangitis
person has gallstone in neck of gallbladder causing acute cholecystitis.
but then gallstone moves into CBD, what type of jaundice can happen now as a complication?
obstructive jaundice
