Acute Cholecystitis
Savio George Barreto, Shailesh V. Shrikhande in Dilemmas in Abdominal Surgery, 2020
Acute acalculous cholecystitis is defined as an acute necro-inflammatory disease of the gallbladder, accounts for 3.7%-14% of acute cholecystitis, and is reported to result from bile stasis and/or ischemia due to the underlying disease state. Most of the patients with acute cholecystitis present with right-upper quadrant abdominal pain lasting several hours, with or without pyrexia. In patients with acute cholecystitis, inflammatory findings such as elevation of white blood cell count, neutrophil count, and C-reactive protein and slight elevation of liver enzymes are often detected in blood investigations. Ultrasound findings of acute cholecystitis are described below, although there is no single ultrasound feature that is useful in the diagnosis of acute cholecystitis. In the patients with severe acute cholecystitis, the rate of complications such as bile leakage, bile duct injury, and bowel injury is reported to be higher than mild or moderate acute cholecystitis.
Effects of physical activity on the gallbladder and biliary tract in health and disease
Roy J. Shephard in Physical Activity and the Abdominal Viscera, 2017
This chapter looks at the impact of acute and chronic physical activity upon biliary function in both health and disease. Although physical activity modifies the secretions and emptying of the healthy gall bladder, the responses to exercise have greater significance for the prevention of disease than for the enhancement of human performance. The potential benefits of physical activity as a means of augmenting emptying of the gallbladder, reducing stasis and protecting against biliary disease have as yet received surprisingly little attention. Nevertheless, a survey of the published literature found 11 reviews that concluded with varying enthusiasm that regular physical activity was helpful in preventing gallbladder disease. Gallstone formation, cholecystitis and cholecystectomy are closely intertwined problems, and many reports have examined the influence of regular physical activity upon all three conditions. Many cross-sectional studies have examined associations between habitual physical activity and some measure of gallbladder disease.
Urology
Kristen Davies in Core Conditions for Medical and Surgical Finals, 2020
The term renal or ureteric colic is used to describe the pain caused by the obstruction of a ureter due to a renal stone. The differential diagnosis for renal stones includes ruptured AAA, pyelonephritis, cholecystitis, pancreatitis, appendicitis, diverticulitis, bowel obstruction, testicular torsion. Immediate management for patients with renal stones is to provide adequate analgesia antiemetic. Ureteric stones in diameter will often pass spontaneously and are managed non-pharmacologically unless there is evidence of infection or anatomical abnormality. Larger ureteric stones and stones that appear to be moving down the ureter may require surgical intervention with ureteroscopy, stone fragmentation and removal, using a small telescope usually along with a laser to break up the stone. Fifty percent of patients will have another renal stone within the decade, so chronic disease management is focused on preventing stone formation. General preventative measures: Specific preventative measures: 13.2 Benign prostatic enlargement is an increase in the size of the prostate gland in the absence of malignancy.
Acute Pancreatitis and Cholecystitis Associated with Postpartum HELLP Syndrome: A Case and Review
Published in Hypertension in Pregnancy, 2007
Satoshi Hojo, Kiyomi Tsukimori, Mio Hanaoka, Ai Anami, Naoyuki Nakanami, Kazuhiro Kotoh, Masahiro Nozaki
We report a case of preeclampsia associated with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and concomitant nonbiliary acute pancreatitis and cholecystitis in the first postpartum day. A thorough investigation ruled out known etiologies of both pancreatitis and cholecystitis. Following conservative treatment, the patient's HELLP syndrome, pancreatitis, and cholecystitis resolved on the third postpartum day. Preeclampsia is associated with microvascular abnormalities that may involve the splanchnic circulation. These abnormalities may cause not only HELLP syndrome but also pancreatitis and cholecystitis. Recognizing that ischemia can damage not only the liver but also the pancreas and gallbladder, could result in improvements in the diagnosis and management of pancreatitis in patients with preeclampsia.
Recurrent Epiploic Appendagitis Mimicking Appendicitis and Cholecystitis
Published in Baylor University Medical Center Proceedings, 2017
Claudia Lorente, Christopher B. Hearne, Jorge Taboada
Epiploic appendagitis (EA) is a rare cause of acute abdominal pain caused by inflammation of an epiploic appendage. It has a nonspecific clinical presentation that may mimic other acute abdominal pathologies on physical exam, such as appendicitis, diverticulitis, or cholecystitis. However, EA is usually benign and self-limiting and can be treated conservatively. We present the case of a patient with two episodes of EA, the first mimicking acute appendicitis and the second mimicking acute cholecystitis. Although recurrence of EA is rare, it should be part of the differential diagnosis of acute, localized abdominal pain. A correct diagnosis of EA will prevent unnecessary hospitalization, antibiotic use, and surgical procedures.
Protector effect of α-thalassaemia on cholecystitis and cholecystectomy in sickle cell disease
Published in Hematology, 2017
Robéria M. Pontes, Elaine S. Costa, Patrícia F. R. Siqueira, Jussara F. F. Medeiros, Andréa Soares, Fabiana V. de Mello, Maria C. Maioli, Isaac L. S. Filho, Liliane R. Alves, Marcelo G. P. Land, Marcos K. Fleury
Objectives: Cholecystitis is one of the complications of symptomatic cholelithiasis responsible for high levels of morbidity of sickle cell disease (SCD) patients. Here, we investigated the possible protective role of single gene deletions of α-thalassaemia in the occurrence of cholelithiasis and cholecystitis in SCD patients, as well as the cholecystectomy requirements. Methods: The α-globin genotype was determined in 83 SCD patients using the multiplex-polymerase chain reaction and compared with clinical events. Results: Overall, in 23% of patients, -α3.7 deletion was found. α-Thalassaemia concomitant to SCD was an independent protective factor to cholecystitis (OR = 0.07; 95% CI: 0.01–0.66; p = 0.020) and cholecystectomy requirement (OR = 0.14; 95% CI: 0.03–0.60; p = 0.008). The risk of cholelithiasis was not affected by the α-thalassaemia concomitance. Conclusions: To the best our knowledge, our study is the first to show the protective effect of α-thalassaemia on cholecystitis and cholecystectomy requirements in SCD, which may be due to an improved splenic function.