Acute cholecystitis Flashcards
3 kinds of gallstones and what causes each one
Pigmented- haemolysis
Cholesterol- Obesity and age
Mixed- Unknown
What are the 3 factors involved in the pathogenesis of gallstones
- High cholesterol levels cause cholesterol gallstones
- How often and how well gallbladder contracts
- Presence of proteins in the liver and bile
What are the risk factors (5 f’s)
Female Fat Fertile Fair Forty
What drugs can cause gallstones
OCP
Fibrates
What are some associated conditions with gallstones
SCD
Cirrhosis
Crohns
Define cholecystitis
Acute gallbladder inflammation due to stone impaction in the cystic duct or gallbladder neck
Is it usually a sterile inflammation or an infection
Sterile inflammation
When it is an infection what bacteria are commonly involved
E. Coli and Klebsiella
What are the common symptoms
Continuous RUQ or epigastric pain
Fever
Vomiting
Local peritonism
What is Boas sign
Tenderness in the back
What is the diagnosis if there is inflammation of the common bile duct
Cholangitis
What is a positive Murphy’s Sign
Pain in the RUQ when 2 fingers are laid over this area and patient is asked to breathe in
What is Phlegmon
Inflammed omentum and bowel around the gallbladder- forming a palpable mass
What preparations need to be made for an abdo CT, and why
4 hours nil by mouth
This will distend the gallbladder
What could be seen on an abdo ultrasound
- stones
- ## thick walled gallbladder and/ or shrunken bladder
