Cholecystitis Flashcards Preview

General Surgery - Phase II > Cholecystitis > Flashcards

Flashcards in Cholecystitis Deck (14)
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1
Q

What is the pathophysiology of acute cholecystitis?

A

Stone impacted in Hartmann’s pouch → inflammation

Some due to DM, burns or sepsis

2
Q

What are the sequelae of acute cholecystitis?

A

Resolution ± recurrence
Gangrene and rarely perforation
Chronic cholecystitis
Empyema

3
Q

What is the presentation of acute cholecystitis?

A

RUQ pain - continuous, can radiate to scapula & epigastrum
Fever
Vomiting
Empyema/Perforation are signs of deterioration

4
Q

What is Murphy’s sign?

A

2 fingers over the gallbladder and ask pt. to breath in → pain + catch breath.

5
Q

What would be seen in the urine of a patient with acute cholecystitis?

A

Bilirubin

Urobilinogen

6
Q

What is the management of acute cholecystitis?

A

NBM
Fluids
Analgesia
Surgery once inflammation resolved

7
Q

What investigations can be performed on a patient with acute cholecystitis?

A

FBC (Increased WCC), U+Es (Dehydration), G+S, Clotting, CRP, Amylase
AXR
USS - ducts dialted >6mm, oedema in GB wall
MRCP if dilated ducts seen on US

8
Q

How does an empyema differ in presentation to acute cholecystitis?

A

RUQ pain, RUQ MASS, fever

Treat with cholecystostomy

9
Q

What are the symptoms for chronic cholecystitis?

A
Flatulence
Dyspepsia
Burping
Distension/bloating
Nausea
*Exacerbated by fatty foods - cholecystokinin release from GB - contraction*
10
Q

What can be seen on investigation of chronic cholecystitis?

A

AXR - porcelain GB
USS - stones, fibrotic, shrunken gallbladder
MRCP

11
Q

What is the management of chronic cholecystitis?

A

ERCP
Cholecystectomy
Can use bile salts as conservative but not very effective

12
Q

What is a gall bladder Mucocele?

A

Stone blocks the neck of the gallbladder, but content remains sterile
Can cause a very large palpable mass
If becomes infected called empyema

13
Q

What would be seen on x ray for gallbladder carcinoma?

A

Porcelain GB due to calcification
Associated with gallstones + GB polyps
Rare

14
Q

What is Mirizzi’s Syndrome?

A

Large stone in GB presses on the common hepatic duct causing obstructive jaundice
Stone may errode through into the ducts