Acute Cholecystitis Flashcards

1
Q

define acute cholecystitis

A

inflammation of gall bladder

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2
Q

how many types are there?

name both types?

A

2

o Calculous cholecystitis

o Acalculous cholecystitis

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3
Q

which is the most common type of cholecystitis?

how common is it % wise?

explain pathophysiology behind this type.

A

Calculous cholecystitis

90%

gallstone stuck in neck of gallbladder or cystic duct –> cholestasis –> gall bladder get inflamed + bacterial overgrowth

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4
Q

what is the most common cause for acute cholecystitis?

A

gallbladder stones

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5
Q

why is there no jaundice with acute cholecystitis?

A

common bile duct open.

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6
Q

if stone moves to common bile duct from neck or cystic duct,

what complication can now happen?

A

Ascending cholangitis

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7
Q

what is gallbladder empyema?

what can this complicate to?

what is treatment for this complication?

A

gallbladder fills with pus

gallbladder perforates

urgent cholecystectomy

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8
Q

1st line Ix for acute cholecystitis?

A

US

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9
Q

LFTs on acute cholecystitis??

A

normal

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10
Q

FBC on acute cholecystitis?

A

leukocytosis with neutrophilia

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11
Q

what is the classical sign for acute cholecystitis?

describe this sign?

A

Murphy’s sign

Severe pain on inspiration when palpating RUQ

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12
Q

is there fever?

A

yes

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13
Q

is there diarrhoea?

A

no

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14
Q

what is the pain like in acute cholecystitis?

  • location
  • radiation
  • character
  • severity
A

RUQ
radiate to shoulder
like biliary colic (crampy)
severe

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15
Q

signs on examination?

-2

A

Murphy’s sign

Gallbladder distention

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16
Q

1st line Mx?

-2 things

A

IV antibiotics & cholecystectomy within 1 week

17
Q

define acute cholecystitis?

vs

define ascending cholangitis?

A

inflammation of gall bladder

Ascending Cholangitis = bacterial infection of biliary tree

18
Q

person has gallstone in neck of gallbladder causing acute cholecystitis.

but then gallstone moves into CBD, what complication can happen now?

A

ascending cholangitis

19
Q

person has gallstone in neck of gallbladder causing acute cholecystitis.

but then gallstone moves into CBD, what type of jaundice can happen now as a complication?

A

obstructive jaundice