Acute cholecystitis

Question 1

What is acute cholecystitis?

Answer 1

Inflammation of the gall bladder due to blockage of the cystic duct by gallstones- prevnting bile to drain

Question 2

Presentation of acute cholecystitis?

Answer 2

RUQ that radiates to R shoulder

With:
* Fever
* Nausea
* Vomiting
* Tachycardia

Murphy’s sign- place a hand in RUQ and apply pressure- ask patient to take deep breath in- gallbladder will come into contact with hand and cause acute pain= murphey’s sign positive

Question 3

Imaging of acute cholecystitis?

Answer 3

1st- abdo ultrasound scan=
* Thickened gallbladder wall
* Stones in gallbladder
* Fluid around the gallbladder

MRCP

Question 4

Management of acute cholecystitis?

Answer 4

Emergency admission:
* Nil by mouth
* IV fluids
* IV Antibiotics
* NG tube if vomiting

ERCP to remove stone
Cholecystectomy- remove gallbladder- within 1 week of diagnosis