Acute cholecystitis

Question 1

What is acute cholecystitis?

Answer 1

Acute inflammation of the gallbladder wall

Question 2

What is cholelithiasis

Answer 2

presence of gallstones

Question 3

Acalculous cholecystitis are not caused by/associated with _____.

Answer 3

gallstones

Question 4

Acalculous cholecystitis can rapidly progress to _____ & ______.

Answer 4

perforation & gangrene

Question 5

Clinical manifestation of acute cholecystitis

Answer 5

• severe right upper abdominal pain, may have radiation to the back
• epigastric pain
• mild fever
• anorexia
• nausea
• vomitting

Question 6

Diagnosis of acute cholecystitis

Answer 6

• Murphy’s sign (can be an indication but NOT reliable in elderly)
• lab tests: elevated WBC count, mild elevation in bilirubin, etc
• hepatobiliary scintigraphy
• ultrasound

Question 7

Management of acute cholecystitis

• drugs:
• if thr is obstruction & infection:
• diet:
• surgery:

Answer 7

• broad spectrum antibiotics (eg. Ampicillin.
  Amoxicillin/clavulanic acid (Augmentin))
• if thr is obstruction & infection: percutaneous catheter drainage with stent placement
• diet: low fat meals
• laparoscopic cholecystectomy

Question 8

Post-op nur management (5)

Answer 8

1. promote fluid balance: monitor I/O for signs of dehy, electrolyte imbalances, etc
2. promote nutrition: NBM until bowel sounds return, then soft, low-fat diet
3. pain relief: analgesia
4. maintain skin integrity at insertion site
5. promote biliary damage

Question 9

Other possible causes of cholecystitis

Answer 9

• bacterial infection in the bile duct system
• tumours of pancreas or liver
• reduced blood supply to gallbladder (may happen if got diabetes)
• gallbladder sludge (mainly in pregnant women)

Question 10

What is gangrene

Answer 10

fatal condition when blood flow to a large area of tissue is cut off– causes tissues to break down & die