Cholecystitis

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Related to emphysematous cholecystitis: emphysematous cystitis, empyema of gallbladder

cholecystitis

[‚kō·lə‚sis′tīd·əs]
(medicine)
Inflammation of the gallbladder.

Cholecystitis

 

an inflammation of the gallbladder that frequently occurs in cholelithiasis (commonly known as gallstone disease), after viral hepatitis and other infectious diseases, and in the presence of a chronic focal infection (such as tonsillitis) or parasitic disease (such as opisthorchosis).

Stoppages or changes in the composition of the bile, which may be related to a person’s diet, are contributing factors in cholecystitis. The condition often occurs in conjunction with cholangitis. Cholecystitis may be acute or chronic. In the acute form, the main symptoms are intermittent pain in the right abdomen radiating to the right shoulder and shoulder blade, nausea and vomiting, chills and elevated body temperature, and sometimes jaundice and pruritus. Peritonitis is a possible dangerous complication of acute cholecystitis. The symptoms of chronic cholecystitis are nausea, a dull pain in the right hypochondrium, and other disagreeable sensations after eating. Laboratory tests and cholecystocholangiograms are important means of diagnosing cholecystitis.

Conservative treatment of cholecystitis and other inflammatory diseases of the biliary tract is aimed chiefly at suppressing the infection (by means of antibiotics and other antimicrobial agents) and increasing the outflow of bile (by special diet, cholagogues and antispasmodics, duodenal probing, and mineral waters such as Borzhom and Essentuki no. 4). Foods that are mechanically or chemically irritating are eliminated from the diet. In the case of acute cholecystitis, surgery is resorted to when conservative therapy is ineffectual. If the disease is chronic, an operation (cholecystectomy) is performed if indicated in the given case after a careful and comprehensive examination of the patient. An operation is not indicated for functional disturbances of the gallbladder (biliary dyskenesia).

REFERENCES

Fedorov, S. P. Zhelchnye kamni i khirurgiia zhelchnykh putei, 2nd ed. Leningrad-Moscow, 1934.
Vishnevskii, A. A., E. V. Grishkevich, and D. S. Sarkisov. Khronicheskii kal’kuleznyi kholetsistit i ego khirurgicheskoe lechenie. Leningrad, 1967.
Nogaller, A. M. Zabolevaniia zhelchnogo puzyria i zhelchnykh putei. Moscow, 1969.
Petrov, B. A., and E. I. Gal’perin. Khirurgiia vnepechenochnykh zhelchnykhprotokov. Moscow, 1971.
Khirurgiia pecheni i zhelchnykh protokov. Edited by A. A. Shalimov. Kiev, 1975.
Olivier, C. Chirurgie des voies biliaires extra- et intra-hépatiques. Paris, 1961.
Schwartz, S. Surgical Diseases of the Liver. New York, 1964.

V. R. ANAKHASIAN

References in periodicals archive ?
Reports of Clostridium perfringens related emphysematous cholecystitis after ERCP are exceedingly rare, and to our knowledge there have only been 4 previously reported cases [6].
Clostridium perfringens-related emphysematous cholecystitis most commonly presents spontaneously as an acute cholecystitis type picture in elderly, acutely unwell patients, with RUQ pain, raised LFTs, and inflammatory markers [2, 8, 9].
In this current case, there was a significant delay in the diagnosis of Clostridium perfringens-related emphysematous cholecystitis, which fortunately appears to have had no lasting sequelae for the patient.
Martin, "Acute emphysematous cholecystitis. Report of twenty cases," Hepato-Gastroenterology, vol.
The surgical specimen revealed perforated emphysematous cholecystitis and biliary sludge.
Acute emphysematous cholecystitis at presentation may also mimic uncomplicated acute cholecystitis [8, 12].
As many as 50% of cases of emphysematous cholecystitis are acalculous [6].
As many as 50% of patients with emphysematous cholecystitis have diabetes mellitus, advanced age, or peripheral vascular disease, all of which increase the risk of ischemic damage to organs [6].
Approximately 50% of patients have diabetes mellitus and suffer other types of associated pathology such as nephropathy and arteriopathy leading to emphysematous cholecystitis through hematogenous dissemination.
Emphysematous cholecystitis is less common type (1%) of acute cholecystitis.
Emphysematous pyelonephritis can raise possibility of septic seeding of gallbladder wall leading to Emphysematous cholecystitis. Simultaneous occurrence of both EPN and EC are rare in literature.