Cholecystitis

Question 1

Define cholecystitis

Answer 1

inflammation of the gallbladder

Question 2

Etiologies of cholecystitis

Answer 2

1. could be due to a cystic duct blockage resulting in the gallbladder being inflamed
   - may or may not be stone-related

Question 3

Pathophys of cholecystitis

Answer 3

Stone lodged in cystic duct → blocks bile flow → irritates mucosa → secretes mucus, inflammatory enzymes → inflammation, distention, and pressure

Question 4

physical exam signs expected with cholecystitis

Answer 4

+ve murphy’s sign ➔ pain in RUQ when trying to press on gallbladder/liver with pt inhalation

Question 5

s/s for cholecystitis

Answer 5

+ve murphy sign
constant RUQ pain
Fever + leukocytosis → classic for inflammation

Question 6

Cx for cholecystits

Answer 6

1. Gallbladder perforation/rupture leads to bacteria into bloodstream and sepsis
2. Can progress into choledocholitiasis and cholangitis
3. Porcelain gallbladder: inner gallbladder wall is encrusted with calcium

Question 7

What are the 6Fs that contribute to the formation of gallstones?

Answer 7

Fat
Female
Forty
Flatulence
Fatty foods
Fetus

Question 8

What 2 imaging investigations would you do for cholecystitis?

Answer 8

RUQ U/S
HIDA scan: sees if the gallbladder takes up radioactive dye as it drains down the hepatic duct to help locate the blockage

Question 9

How would you treat cholecystitis?

Answer 9

Offer required cholecystectomy - need to remove to ensure the gallbladder doesn’t infarct

Consider giving antimicrobials/antibiotics