cholecystitis

Question 1

definition

Answer 1

acute inflammation of the gallbladder, most commonly caused by gallstones

Question 2

pathology

Answer 2

gallstone blocking cystic duct causing backflow of bile acid, causing infection and inflammation

Question 3

presentation

Answer 3

• generalised epigastric pain - migrating to severe RUQ pain
• right shoulder / intrascapular pain
• signs of inflammation like fever and fatigue
• pain associated with tenderness and guarding from inflammed gallbladder and local peritonitis

Question 4

treatment

Answer 4

antibiotics IV
heavy angelesia
IV fluids
eventual cholecystectomy if needed

Question 4

investigations

Answer 4

• positive murphys sign - severe pain on deep inhalation with examiners hand pressed into RUQ
• FBC CRP
• ultrasound - thick gallstone walls from inflammation and stones in the GB