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Cholecystitis: Pathophysiology and Treatment Department of Surgery
Cholecystitis: Pathophysiology and Treatment Department of Surgery
TREATMENT
Cholecystitis
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ACUTE
CHOLECYSTITIS
CALCULOUS
Etiology
FEVER
SYMPT
OMS
RIGHT INTERSCAPULAR
PAIN
Radiation from RUQ pain
ANOREXIA
- Frequently performed on
patients with acute
abdominal pain
- Demonstrates thickening of
the gallbladder wall as well as
air in the gallbladder.
Gallbladder
perforation and local
abscess
Cholangitis or sepsis COMPLICATIONS
Gallbladder rupture
Biliary enteric
(cholecytenteric)
fistula
Treatment
NON – SURGICAL
• Ketorolac (Preferred)
• Given 30 to 60 mg single dose, IV
• Opioids such as morphine, hydromorphone or meperidine
• For patients contraindicate to NSAIDS
Treatment
NON – SURGICAL
Gallbladder drainage
• High surgical risk such as being septic or critically ill
• No appreciable clinical improvement after 1-3 days of
nonoperative management with antibiotics
• Decompresses infected bile or pus from the gallbladder
• Allows both local inflammation and systemic illness to resolve
before gallbladder removal
I W
Treatment
SURGICAL A A
Cholecystectomy
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CHRONIC
CHOLECYSTITIS
Etiology
RIGHT INTERSCAPULAR
PAIN
Radiation from RUQ pain
SYMPT
OMS
Pathophysiology
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