Acute Cholecystitis - Causes, Symptoms, Diagnosis, Treatment & Pathology (Health And Medical Video July 2018).

What is cholecystitis, what are its causes, signs and treatments.

Cholecystitis is an inflammation of the gall bladder. There are acute cholecystitis and chronic. Chronic differs from acute long-term development, with alternating exacerbations and remissions when the bubble troubles are not observed at all.

If during the examination the gallstones in the lumen of the gallbladder are reliably detected, this cholecystitis is called calculous. Such cholecystitis is a manifestation of gallstone disease. But not always the inflammation of the gallbladder is caused by the formation of stones. There are not rarely cases in which, when extremely pronounced inflammation, even in the purulent defeat of the walls of the bubble, stones (concretions) do not even appear, even during an open operation.


It is believed that provocative factors are irregular diet, abuse of greasy and fried foods. If irregular nutrition can contribute to stagnation of bile in the bubble, then smoked and fatty meat can cause bubble strain, up to spasms. Failure of the gallbladder outflow, in addition to stones, can also be caused by obesity or pregnancy. The primary disruption of the ability of the bubble to throw bile into the duct (dyskinesia) also theoretically increases the risk of getting sick. By the way, the diagnosis of dyskinesia of the gall bladder is very fond of exposing children unreasonably, thus trying to explain the uncertain pains in the right hypochondrium. The diagnosis of this is easily used in children's clinics only on the basis of ultrasound of the abdominal cavity, and sometimes even without it. And, meanwhile, contractile activity of the gallbladder on ultrasound is not determined at all. Data on the functions of the bubble can only be obtained with the help of contrast X-ray, which is performed in hospitals, on special indicators and very infrequently.


The most common symptom of gallstone inflammation is pain. Usually this painful, medium intensity, concentrates in the right hypochondrium. Pain may be given to the right collarbone, right shoulder, but this symptom is not clearly expressed. To think about inflammation of the gall bladder may be the association of such pain with eating. The pain may occur about an hour or so after eating, especially when using greasy, roasted or smoked food. Truly provoking products can be chocolate, soda water, spices, eggs, turnips, onions, oils, ice cream, coffee and sour berries. It is these products, as well as some others, are excluded from the diet to avoid aggravation of the disease. This diet is called liver or table number 5.

Other symptoms are less typical: abdominal distension, signs of indigestion, heartburn, irritability. They can be taken for symptoms of gastroduodenitis and even ulcers of the stomach.

If the pain attacks are very intense, they are called bilious colic. A distinctive feature of the biliary colic, usually caused by gallstones, is a sharp relief after admission or administration of antispasmodics. It is the spasm of the gall bladder, or rather its neck, that is the cause of such pain. On the background of spasm of the cervix or blockage of gallstone, the bubble is unsuccessfully trying to empty, which even more annoying its walls. Due to the inflammation of the bile in the lumen of the gall bladder begins to admire inflammatory effusion, which increases stretching and irritation of the walls. Patients with modest fecundity may find that the right hypochondrium is full of stretched gall bladder, but usually patients are prone to a fairly thick subcutaneous fat.


Cholecystitis is finally diagnosed with ultrasound. The ultrasound allows not only to identify the gallstones, if they exist, but to determine the degree of change in the walls of the bubble, and therefore to identify the stage of inflammation, and even estimate the disease's history. Of course, the diagnosis is in combination with other methods of diagnosis (general and biochemical blood tests, general urine analysis, etc.), but ultrasound data are decisive. The collection of bile portions, which has not been canceled by anyone, is used today extremely rarely and only for specific indicators.


The gallbladder, compromised himself with a penny and regular attacks, is a candidate for removal. Even if stones are not detected in the lumen of the inflamed bubble, altered mucus can be the cause of their formation. And the bladder inflammation can quickly go to the purulent stage (phlegmonous cholecystitis), dangerous development of peritoneal inflammation (peritonitis). Peritonitis is life-threatening, therefore, to prevent it, the gallbladder is surgically removed. The classic open cholecystectomy (removal of the gallbladder) allows us to conduct a qualitative review and revision of the state not only of the bubble but also of the duct. Although such an operation is very traumatic and requires a long recovery. Therefore, as a better alternative, a laparoscopic operation, which is performed without cuts, has been introduced for a long time and is delivered to the flow, which is performed without cuts, through punctures in the abdominal wall. This method of removal of the gall bladder in all developed countries is a "golden" standard for the treatment of calculous cholecystitis. The patient may already leave the hospital for 2 days, the abdominal wall is not injured by a wide incision.

But this operation is possible only in the absence of complications (blockage of the bile duct, inflammation of the peritoneum, gallbladder gangrene).

The removal of the gall bladder does not significantly affect digestion. The bile continues to enter the intestines and participate in the digestion of fats. But it ceases to accumulate before eating, because the gall bladder is, by function, a bile storage device. Rarely, the removal of the bubble leads to a complex of complaints, called "post-hole cystectomy syndrome" (PCEC).


Category Of Medical Issues: Diseases

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