Gallstones, also known as gallstones, can effectively make life difficult. Cholecystitis is often associated with urolithiasis. However, does the stone lead to acute cholecystitis, or does the inflammation contribute to the formation of stones? Experts say both hypotheses are probable. What are the symptoms of acute cholecystitis? How is the treatment going?

Acute cholecystitisis primarily a commoncomplication of gallstone disease . With acute cholecystitis, strong, sharp pains in the right epigastric region radiating to the right scapula are characteristic. The pain is usually colic, usually lasting more than 6 hours.

Acute cholecystitis: causes

The most common cause of acute cholecystitis is gallstone disease. The problem arises when the stones obstruct the outflow of bile from the gallbladder - inflammation occurs as a result of irritation of the gallbladder walls. Later (after about 48 hours), bacterial infections (E. coli, enterococci, Klebsiella, Enterobacter, C. perfringens) may develop through the bloodstream.

In 5-10 percent of cases, acute cholecystitis is not related to cholelithiasis and is caused by abdominal surgery, abdominal injuries, severe burns or sepsis.

Important

Acute cholecystitiscan also develop without stones. This applies to 10 percent. cases of the disease and may be a consequence of a general bacterial infection. In children, these are usually streptococci, typhoid bacteria. Acute vesiculitis is also seen in people with diabetes.

Acute cholecystitis: symptoms

Acute cholecystitis is manifested by severe pain located on the right side of the abdomen, just below the ribs. It is often accompanied by nausea, vomiting and increased temperature. The skin on the abdomen is tense, and when the painful area is pressed more firmly under the fingers, a lump is felt. The pain intensifies when you draw in air, sometimes it radiates to your back and ribs.

Such symptoms are characteristic of the onset of acute inflammation. After 24 hours, the discomfort usually becomes lessannoying. However, this does not mean that the inflammation is going away. On the contrary, a sick person is in serious danger. The walls of the follicle, weakened by inflammation, may rupture. The effects of this are hard to predict and not easily healed.

Acute cholecystitis: conservative treatment

Treatment is to avoid anything that might irritate the gallbladder. Maintaining a strict diet plays an important role here. The patient must take painkillers and antibiotics. But such treatment can only be used for a short time as there is a risk of the pouch bursting.

It has been accepted that when symptoms of acute inflammation do not improve within 48 hours, surgery is required. It consists in removing the bubble. A patient who is offered an operation by a doctor should not delay. Postponing the procedure may be life-threatening.

Acute cholecystitis: operation

The most popular surgery is cutting the abdominal wall and removing the follicle. But minimally invasive surgery is also becoming popular. Laparoscopy is used for this. The device, armed with a suitable tool (grippers), allows you to remove the bubble through a small incision. The procedure is performed under general anesthesia.

After three days, the patient can leave the hospital. Sometimes, however, complications arise, or it is only during endoscopic surgery that the stones are too large to be removed through a tiny opening, and you need to switch to the traditional surgical method. The patient is informed about such eventuality before the procedure.

Stones from the bubble can also be removed with the ERC method. Special tools are used for this, which are inserted through the endoscope into the bile ducts to transfer deposits from the duct to the intestine. This is how you can get rid of small stones. Large ones can be moved to the intestine after cutting the muscle in the Vater's papilla. Although there is a possibility of complications, 90 percent. such treatments are successful.

Acute cholecystitis: complications

Possible complications in acute cholecystitis are:

  • transition from acute to chronic
  • hydrocele of the gallbladder, when the contents of the gallbladder are not infected
  • necrosis of the gallbladder
  • empyema of the gallbladder, caused by a bacterial infection of the contents in the gallbladder
  • gallbladder perforation with peritonitis
  • biliary peritonitis without gallbladder perforation, possibly caused by bile drainage into the peritoneum
  • biliary obstructioncaused by closure of the gastrointestinal lumen by a large gallstone which has passed through the fistula with the duodenum, stomach or intestine
  • Diet for gallbladder problems. Menu when the gallbladder is ill
  • Gall bladder: resection. For and against vesicle surgery
  • Hepatic colic - a common problem in women in their forties
  • Biliary obstruction - symptoms, cholestasis, treatment
  • Hida test - biliary obstruction test

Category:

Gastrology