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Cholecystitis

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Cholecystitis

  1. 1. Dr. Soumar Dutta Guwahati Refinery Hospital
  2. 2. Anatomy
  3. 3. Gallstones(Cholelithiasis) <ul><li>4F: F at F ertile F emale of F orty </li></ul><ul><li>Pathogenesis: </li></ul><ul><li> 1. Metabolic Factor. </li></ul><ul><li> 2. Stasis of bile. </li></ul><ul><li> 3. Infective . </li></ul><ul><li>Types of Gallstones : Three types </li></ul><ul><li> A. cholesterol stones: composed of cholesterol </li></ul><ul><li> solitary, smooth surface </li></ul><ul><li> oval/round shape </li></ul><ul><li> pale-yellow coloured </li></ul>
  4. 4. <ul><li>Pigment stones: consist of Ca-bilirubinate </li></ul><ul><li>Black /Dark brown </li></ul><ul><li>Associated with raised bilirubin production-haemolysis </li></ul><ul><li>Small, multiple, soft putty-like-masses . </li></ul><ul><li>Mixed stones : Composed of : </li></ul><ul><li> Cholesterol. </li></ul><ul><li> Bile pigments. In varying proportions </li></ul><ul><li> Calcium </li></ul>
  5. 5. EFFECTS AND COMPLICATIONS OF GALLSTONES In the gall bladder silent stone perforation Ac. Cholecystitis empyema Chr. Cholecystitis mucocele Gangrene carcinoma In the bile duct: obstructive jaundice cholangitis Acute pancreatitis In the intestine: Acute intestinal obstruction [gallstone ileus]
  6. 6. CHOLECYSTITIS: It is an inflammatory condition of the gall bladder. 1. Acute 2. Chronic (a) Secondary chronic cholecystitis (b) Primary chronic cholecystitis ACUTE CHOLECYSTITIS: 90% associated calculi PATHOLOGY . Obstruction or stasis . Chemical irritation . Bacterial Infection
  7. 7. Clinical features: Dyspeptic symptoms. Right subcostal pain Pyrexia Jaundice Investigation: Routine blood ECG USG(upper abdomen ) X-Ray of the abdomen cholescintigraphy Treatment: conservative treatment followed by cholecystectomy Nasogastric aspiration and IV fluid administration Analgesics Broad spectrum antibiotics surgical treatment: Cholecystectomy
  8. 8. Chronic Cholecystitis Two variety: secondary chronic cholecystitis primary chronic cholecystitis Clinical features: vague and insidious in onset Intolerance to fatty food Belching Postcibal epigastric distension Nausea and vomiting. Pain usually follows meal Investigations: Blood routine Oral cholecystography USG Treatment: Cholecystectomy is the definitive treatment
  9. 10. THANK YOU

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