Inflammation of the wall of the gallbladder in the penetration of germs. Perhaps as a background of gallstone disease, and in the absence of stones. Most women suffer.
Symptoms and over:Typically an acute onset after errors in diet:. Hearty, greasy, fried or spicy foods, alcohol, confectionery cream, mushrooms, etc. Pain in the right upper quadrant usually strong (as with biliary colic), is given in the back, right shoulder, right supraclavicular region. If pancreatitis is attached, they are distributed to the left hypochondrium. Elderly people suffering from coronary heart disease, while there may be pain on the left of the sternum and the sternum - reflex angina. Many patients - nausea and vomiting, first eaten food in the future - an admixture of bile or bile. The temperature rises from low to high subfebrile. On palpation of the abdomen is determined by tenderness in the right upper quadrant and the stomach, the abdominal muscles are tense, 2-4 days begins painfully palpable tense gall bladder in the form of a rounded education and painful enlarged liver. Pulse is speeded up, blood pressure tends to decrease in the majority of patients 2-3 days appears yellowness of the skin, sclera and mucous membranes.
There are the following forms of acute cholecystitis.
Bluetongue form occurs with low-grade fever, mild pain lasting from 2 to 7 days, slight changes in blood tests - a leukocytosis to 12000. Timely and proper drug therapy leads to recovery, otherwise it may go in the form of abscess.
Phlegmonous cholecystitis expressed harder: severe pain, often vomiting, neprinosyaschaya relief, high temperature (38-39 ± C), chills, severe weakness, loss of appetite, blood tests marked leukocytosis.
Gangrenous cholecystitis is more severe than the abscess, the temperature is above 39 ± C, often joins peritonitis - an inflammation of the peritoneum. Without timely surgery can be fatal.
In older people, even phlegmonous and gangrenous cholecystitis are not always clearly delineated: the temperature increase may be small, the pain and symptoms of peritoneal irritation are mild or absent.
Complications of acute cholecystitis include perforation (wall integrity violation) of the gallbladder and the subsequent development of purulent or bile peritonitis, fistulas or abscesses, acute cholangitis. Obstruction of bladder neck or duct with a large stone wedging leads to stretching of the gallbladder, if mucus, then it is called "mucocele" transparent transudate - "dropsy", pus - "empyema". The concomitant inflammation of the pancreas - pancreatitis reactive rather frequent complication.
Detection of acute cholecystitis is difficult, because its manifestations are similar to other diseases of the abdominal cavity: acute appendicitis, pancreatitis, perforated gastric ulcer and 12 duodenal ulcer, right-sided renal colic and acute pyelonephritis. Diagnosis is based on clinical tsa, from laboratory data are important white blood cell count. Ultrasound reveals stones in the bile ducts, gallbladder wall edema, its size, the state of the main bile duct. From X-ray methods is set to review a snapshot of the abdominal cavity.
Treatment:Patients with acute cholecystitis, regardless of the state should be hospitalized in the surgical department of a hospital. Appointed by bed rest, hunger, water bottle with ice on his right upper quadrant. The injections are administered antispasmodics, baralgin, analgin. Detoxification therapy is carried out by intravenous administration of 5% glucose solution, saline, gemodeza total of 3.2 liters per day. Appointed by broad-spectrum antibiotics. If within 24 hours of intensive treatment of inflammation does not subside, the patient shows surgery - removal of the gallbladder (cholecystectomy).