Gallbladder Flashcards
Where is the gallbladder
below the liver
What does the gallbladder store
bile until it is released into the cystic duct
What is cholecystitis
inflammation of the gallbladder (can be acute or chronic)
Risk factors for cholecystitis
women, age 40+, high calorie and cholesterol diet, oral contraceptives, genetics, obesity, rapid weight loss
When does cholecystitis most commonly occur
biliary stasis and gallstones
Calculous cholecystitis
caused by gallstones that lodge in the cystic duct (90% of all cases)
Acalculous cholecystitis
caused without evidence of gallstones or cystic duct obstruction
Pathophysiology of cholecystitis
obstruction of the cystic duct by gallstones –> distension of the gallbladder –> compromised blood flow and lymphatic drainage –> necrosis
What causes cholecystitis pain
irritation of surrounding nerves from gallbladder distension
Biliary colic
pattern of spasmodic pain
Biliary stasis
problem with the liver that inhibits its ability to secrete bile into the bile ducts
What causes biliary colic
decreased distension, pain decreases
Chronic cholecystitis
when the gallbladder becomes thickened, rigid, and fibrotic
What causes changes in gallbladder structure
multiple attacks of cholecystitis, calculi, chronic irritation
Laboratory tests to diagnose cholecystitis
WBC, ESR, CRP, liver enzymes, bilirubin levels
Abnormal ultrasound findings in cholecystitis
presence of stones, thickening of the wall, distension
Cholecystogram
assessment of gallbladder function, special diet is consumed before and contrast tablets are taken
Diet treatment of cholecystitis
avoid food during acute attacks, NG tube to relieve nausea and vomiting, limit fat intake, fat-soluble vitamins and bile salts if bile flow is obstructed
Medication treatment of cholecystitis
narcotic analgesic, oral meds to dissolve gallstones, meds to bind with bile salts to promote excretion in the feces in patients with pruritis
What narcotic analgesics are used
dilaudid because morphine can cause spasms in the biliary duct increasing pain
What medication is used to dissolve gallstones
Ursodiol
What medication is used in patients with pruritis to promote excretion of bile salts in the feces
Questran
When are laparoscopic cholecystectomies used
used in cases of both cholelithiasis and cholecystitis
What is a laparoscopic cholecystectomy
removal of the gallbladder
Transhepatic tube use
maintains patency of common bile duct, promotes bile passage, decreases edema
