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Acute Cholecystitis
General Surgery
Acute Cholecystitis is an acute inflammation of the gallbladder, usually caused by the obstruction of the gallbladder outlet or infection of the bile duct. The infection associated with acute cholecystitis can spread to other areas and even lead to severe systemic infections such as pancreatitis and peritonitis.
Symptoms
Here are possible symptoms of acute cholecystitis:
- Severe right upper abdominal pain: The most typical symptom is intense pain in the correct upper or upper abdomen, sometimes radiating pain to the right shoulder and right side of the back.
- Nausea and vomiting: The obstruction of bile excretion may cause stomach bloating and discomfort.
- Fever: Inflammatory conditions accompanying acute cholecystitis may lead to an elevated body temperature.
- Jaundice: If cholecystitis obstructs the bile duct, it may yellow the skin and eyes.
- Abdominal Bloating: The abdomen may feel swollen and uncomfortable.
Factors
- The majority of cases of acute cholecystitis are caused by gallstones blocking the cystic duct. It leads to the stagnation of bile inside the gallbladder, providing a conducive environment for the rapid growth of bacteria. In a short period, this can result in inflammation of the entire gallbladder or severe consequences such as sepsis.
- The remaining cases are non-gallstone-related acute cholecystitis caused by factors such as trauma, sepsis, burns, or specific vascular abnormalities.
Diagnosis
- Clinical diagnosis: Includes questioning symptoms and conducting abdominal examination.
- Blood tests: Measure white blood cell count and test biomarkers for gallbladder inflammation.
- Ultrasound: Used to detect gallstones and assess the condition of the gallbladder.
- CT/MRI Scans: Provide more detailed images to confirm the diagnosis.
- Gallbladder function tests: Evaluate the function of the gallbladder.
Treatment
| Medical treatment: | Includes pain relievers, antibiotics, and electrolyte solutions to alleviate pain and combat infection. |
| Percutaneous Transhepatic Gallbladder Drainage (PTGBD) | It is entering the gallbladder through puncturing the liver, using a drainage tube to remove fluid from the gallbladder. It is mainly used to treat gallbladder-related issues, typically gallbladder fluid accumulation or gallbladder inflammation. |
| Gallbladder Removal Surgery | When conservative treatment fails to improve the condition, gallbladder removal surgery can address other bile duct stone problems simultaneously. |
| Laparoscopic Cholecystectomy | One of the most advanced surgical methods is considered minimally invasive surgery. Advantages include:
It is currently one of the best surgical methods for acute or chronic gallbladder inflammation. |
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