Cholecystitis

Question 1

Cholesystitis

Answer 1

Inflammation of the gallbladder, associated with gallstones in greater than 90% of cases

Question 2

Cholecystitis Signs/symptoms

Answer 2

Often precipitated by a large or fatty meal

He said an appearance of steady, severe pain in epic gastrium or right hypochondrium

Vomiting in patients affords relief

Question 3

Cholecystitis Physical findings

Answer 3

** Murphy’s sign: deep pain on inspiration while fingers are placed under the right rib cage

Right upper quadrant tenderness to palpation; palpable gallbladder and 15% of cases

Muscle guarding and rebound pain

Fever

Question 4

Cholecystitis lab/diagnostics

Answer 4

WBCs 12–15
Serum bilirubin may be elevated
Serum ALT, AST, LDH, and alkaline phosphatetase levels are increased
Amylase may be elevated
** ultrasound: gold standard most effective imaging test
Plane films may show radio peak gallstones
HIDA scan

ERCP: used to diagnose disease of the gallbladder, bile system, pancreas, and liver

Question 5

Cholecystitis Management

Answer 5

Pain management
In GT for gastric decompression
Maintain NPO
Crystalloid solution
Surgical consultation for laparoscopic cholecystectomy