Acute Cholecystitis (Gallstones)

Question 0

Clinical picture

Answer 0

• Constant pain (not colic like)
• Peritonism in upper quadrant
• Pyrexia
• Raised WCC
• Paralytic ileus
• Murphey’s sign (pressure on R. hypochondrium and ask pt to inhale deeply)

Question 1

Classification

Answer 1

a. White –> Cholesterol
b. Black –> Haemoglobin
c. Mixed

Question 3

Charcot’s Triad

Answer 3

• Pain (RUQ)
• Jaundice
• Rigors

Question 5

Risk factors for gallbladder neck obstruction

Answer 5

• Fair
• Forty
• Fat
• Flatulent
• Foetus

Question 6

Investigations

Answer 6

• U/S

- Endoscopic Retrograde Cholangiopancreatogaphy (ERCP)

Question 7

Management

Answer 7

• Cholecystectomy
• Analgesia
• Broad spectrum IV antibiotics

Question 8

Complications

Answer 8

“Mirizzi Has Gallstones And Often Becomes Ill”

M - Mirizzi syndrome
H - Haemorrhagic pancreatitis 
G - Gallbladder neck obstruction
A - Acute cholecystitis
O - Obstruction of common bile duct
B - Biliary colic (Chronic Cholecystitis) 
I - Gallstone ileus