Acute Cholecystitis – What it is, Symptoms and Treatments of this condition. In addition, Acute Cholecystitis is one of the most frequent diseases in emergencies worldwide. Obstruction of the bile duct by a stone, in 90% of cases, leads to acute inflammation of the gallbladder in most cases. There is a colic that soon turns into intense pain in the right hypochondrium, nausea , vomiting and fever in 70% of patients.
Acute Cholecystitis can become very serious and, in most cases, requires immediate medical attention. See your doctor as soon as possible if you think you have Acute Cholecystitis . This condition can become chronic if it persists for an extended period of time, or if you are having recurring symptoms of inflammation .
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Causes of Acute Cholecystitis: Any factor that causes accumulation of bile in the gallbladder (vesicular stasis) can determine the inflammation of the organ, preventing it from continuing to perform its normal functions, triggering Acute Cholecystitis . And, if the stones appear, the friction with the walls increasingly accentuates the irritation of the mucosa.
If stasis occurs, bile is not eliminated and large amounts of its component elements – salts, acids and lipids – are deposited on the walls of the vesicle. This abnormal deposition can cause inflammatory reactions. It is common that, in the walls of the inflamed vesicle, an abnormal deposit of lipids, especially cholesterol, associated with acids and salts is found.
Symptoms of Acute Cholecystitis: The most common presenting symptom of Acute Cholecystitis is upper abdominal pain. The following characteristics can be reported:
- Signs of peritoneal irritation may be present and the pain may radiate to the right shoulder or scapula;
- Pain usually starts in the epigastric region and then localizes to the right upper quadrant (RUQ);
- The pain may initially be cramping, but it almost always becomes constant;
- nausea and vomiting are usually present, and fever may be noted.
Patients with acute calculous cholecystitis may present with fever and sepsis alone without a history or physical examination, findings consistent with acute cholecystitis . Cholecystitis may present differently in special populations, as follows:
Elderly (especially diabetics) – May present with vague symptoms and without many fundamental historical and physical findings (eg, pain and fever ), with localized tenderness the only presenting sign; It can progress rapidly against complicated cholecystitis and without warning;
Children – may present without many of the classic findings; Those most at risk for cholecystitis include those who have sickle cell disease, severe illness, prolonged total parenteral nutrition (TPN) requirement, hemolytic conditions, or congenital and biliary anomalies .
Diagnosis of Acute Cholecystitis: The symptoms of Acute Cholecystitis can resemble many other diseases. Therefore, your doctor will want to know about your medical history as well as your symptoms. He will likely check your abdomen for areas of swelling or tenderness, as well as order additional tests such as:
- Abdominal ultrasounds: Sound waves to create an image of your organs.
- Villus scintigraphy is a procedure that creates an image of the upper portion of the small intestine, liver, gallbladder, and bile ducts .
- Cholangiography uses dye injected into bile ducts to show the gallbladder and bile ducts on an x-ray.
- CT Scan: Computerized images used to create images of your internal organs.
If your doctor has determined the presence of Acute Cholecystitis , he may also order blood tests to determine if there are any other problems. For example, liver function tests can be abnormal with this condition and check white blood cell counts .
Treatments for Acute Cholecystitis: The treatment for Acute Cholecystitis consists of immediate hospitalization, as soon as the problem is diagnosed, so that the patient is taken care of with medications that can relieve symptoms as quickly as possible.
At first, a treatment based on medication is carried out, and then the surgical process follows. This is so that the patient does not suffer complications from the surgery, if it is performed immediately. It is important to relieve the symptoms of Acute Cholecystitis , perform tests that can assess the clinical conditions of the patient who will undergo surgery.
When Acute Cholecystitis is diagnosed, the problem and the patient’s conditions are favorable for the surgical process, it is important that it is carried out quickly, as the gallbladder crisis can return causing more pain and complications to the patient.