Cholecystitis Flashcards
1
Q
Definitions of
- Cholelithiasis
- Choledocholithiasis
- Cholangitis
- Cholecystitis
A
- Cholelithiasis - gallstone in the gallbladder
- Choledocholithiasis - gallstone in the biliary tree
- Cholangitis - inflammation of the bile duct
- Cholecystitis - inflammation of the gallbladder
2
Q
Proportion of people with gallstones who develop cholecystitis
A
1/3
3
Q
Risk factors for gallstones (5)
A
- Fat (overweight)
- Female
- Forty
- Fertile (pregnancy)
- Drugs (especially hormonal)
4
Q
Acalculous cholecystitis
- Percentage of cholecystitis
- Aetiology
- Risk factors
A
- 10%
- Bile stasis
- Major illnesses/trauma/surgery and prolonged fasting
5
Q
Symptoms of cholecystitis (4)
A
- RUQ or epigastric pain - constant >5 hours, may radiate to right shoulder/scapula
- Nausea and vomiting
- Fever
- Jaundice
6
Q
Symptoms of cholangitis (3)
A
Charcot’s triad
- Fever
- Jaundice
- RUQ pain
7
Q
Signs of cholecystitis on examination (5)
A
- Fever
- Tachycardia
- RUQ/epigastric tenderness, often with guarding or rebound
- Palpable gallbladder (30-40%)
- Jaundice (15%)
8
Q
Findings for cholecystitis on ultrasound
A
- Dilation of the duct >5mm (stone)
3. Thickening of gall bladder wall >4mm (acute cholecystitis)
9
Q
Management of cholecystitis
A
- Bowel rest
- IV fluids and electrolyte correction
- IV ceftriaxone + metronidazole
- Antiemetics
- Analgesics
- Surgery (25-30% require surgery) - laparoscopic cholecystectomy or ERCP
10
Q
Complications of cholecystitis (2)
A
Perforation
Necrosis
11
Q
Saint’s triad
A
- Gallstones
- Diverticulitis
- Hiatus hernia
