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Wednesday, September 08, 2010
 
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Cholecystitis

Normal

Abnormal
  • This is when the gallbladder becomes infected. It is associated with gallstones more than 90% of the time. When gallstones become impacted in the bile ducts, infection occurs behind the impaction.
  • Often starts after a large fatty meal
  • Sudden, steady pain in the middle or right upper abdomen
  • Vomiting
  • Fever
  • Gallstones
  • Ischemia (blood supply decrease to gallbladder)
  • Infections in persons with AIDS
  •  
    • Examination:
      1. Tenderness in right upper abdomen
      2. Gallbladder can be felt in some cases
      3. Yellow skin or eyes may occur
    • Laboratory Findings:
      1. Elevated white blood cell count
      2. Elevated total Bilirubin level
      3. Elevated Alkaline phosphatase
      4. Amylase may be moderately elevated
    • Imaging
      1. X-Rays may who gall stones
      2. HIDA scan (special X-Ray test for obstructed gallstones)
      3. Ultrasound may show gallstones or thickened gallbladder wall
     
    • Bowel rest (no food or drink)
    • Intravenous fluid/feeding
    • Intravenous broad-spectrum antibiotics
    • Pain medications (Demerol usually best)
    • Surgical removal of the gallbladder 2-3 days after cholecystitis for most patients
    • Immediate surgical gallbladder removal if gangrene has occurred
    Seek immediate emergency medical treatment.
  • Untreated gangrene in the gallbladder may occur. This is a severe infection with destruction of tissue. Diabetics and the elderly are at highest risk.
  • Cholangitis -- infection that occurs in common bile duct outside the gallbladder
  • Perforated ulcer
  • Pancreatitis
  • Appendicitis
  • Liver Abscess
  • Hepatitis
  • Pneumonia (in right lung)
  • Gallstones

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