CHOLECYSTITS

Profesora
Christian Ponce

Student
Christian Ponce

Cholecystitis

INDICE

I. II. III. IV. V. VI.

Introduction Definition Causes Classification Diagnosis Treatment

VII. Bibliografia

Cholecystitis
I.
Bile is a fluid made in the liver. Bile contains various substances, including bile pigments, bile salts, cholesterol and lecithin. Bile is passed into tiny tubes called bile ducts. The bile ducts join together (like the branches of a tree) to form the main bile duct. Bile constantly drips down the bile ducts, into the main bile duct, and then into the gut.

Introduction

The gallbladder lies under the liver on the right side of the upper abdomen. It is like a pouch which comes off the main bile duct and fills with bile. It is a 'reservoir' which stores bile. The gallbladder contracts (squeezes) when we eat. This empties the stored bile back into the main bile duct. The bile passes along the remainder of the bile duct into the duodenum (the first part of the gut after the stomach). Bile helps to digest food, particularly fatty foods

II.

Definition

Cholecystitis is inflammation of the gallbladder. Most cases are caused by gallstones. The inflammation may settle down with treatment. However, removal of the gallbladder is usually advised to prevent further bouts of cholecystitis Cholecystitis means inflammation of the gallbladder. However, it is not an uncommon condition, and it is quite a common cause for hospital admission. Women are affected more often than men.

III.

Causes

Most cases of cholecystitis are caused by gallstones Gallstones occur when bile, which is normally fluid, forms stones. Gallstones commonly contain lumps of cholesterol-like (fatty) material that has solidified and hardened. Sometimes bile pigments or calcium deposits form gallstones. Sometimes just a few small stones are formed; sometimes a great many. Occasionally, just one large stone is formed. About 1 in 3 women, and 1 in 6 men, form gallstones at some stage in their life. They become more common with increasing age. Most people with gallstones do not have any symptoms or problems, and do not know they have them. Commonly, the stones simply stay in the gallbladder and cause no harm. However, in some people, gallstones can cause problems. (See separate leaflet called 'Gallstones' which briefly lists the various problems that gallstones can cause.)

Cholecystitis is one problem that can occur with gallstones. About 19 in 20 cases of cholecystitis are thought to be caused by gallstones. What seems to happen is that a gallstone becomes stuck in the cystic duct (this is the tube that drains bile out from the gallbladder into the bile duct). Bile then builds up in the gallbladder, which becomes stretched (distended). Because of

this, the walls of the gallbladder become inflamed. In some cases the inflamed gallbladder becomes infected. An infected gallbladder is more prone to lead to complications (see below). Other causes of cholecystitis are uncommon No gallstones are found in about 1 in 20 cases of cholecystitis. In many of these cases it is unclear as to why the gallbladder became inflamed and/or infected

IV. Classification
Cholecystitis is classified as acute or chronic. Acute Cholecystitis: Acute cholecystitis begins suddenly, resulting in severe, steady pain in theupper abdomen. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later.Inflammation may cause the gallbladder to fill with fluid and its walls to thicken.Rarely, a form of acute cholecystitis without gallstones (acalculous cholecystitis) occurs.Acalculous cholecystitis is more serious than other types of cholecystitis. It tends to occur after the following: Major surgery Critical illnesses such as serious injuries, major burns, and bodywide infections (sepsis) Intravenous feedings for a long time Fasting for a prolonged time A deficiency in the immune systemIt can occur in young children, perhaps developing from a viral or another infection. Chronic Cholecystitis: Chronic cholecystitis is gallbladder inflammation that has lasted a longtime. It almost always results from gallstones. It is characterized by repeated attacks of pain(biliary colic). In chronic cholecystitis, the gallbladder is damaged by repeated attacks of acuteinflammation, usually due to gallstones, and may become thick-walled, scarred, and small. Thegallbladder usually contains sludge (microscopic particles of materials

similar to those ingallstones), or gallstones that either block its opening into the cystic duct or reside in the cysticduct itself.

V.

Diagnosis

In addition to obtaining your medical history, your doctor may also order blood tests to determine if there is an infection in the gallbladder. It also may have one or more of the following imaging tests Abdominal Ultrasound Ultrasound uses sound waves to produce images of the gallbladder and may also display some of the bile ducts. Used to identify signs of inflammation or to demonstrate that there may be a blockage of bile flow.

Abdominal CT: computed tomography (CT) occurs very quickly detailed images of the abdomen, including the gallbladder and bile ducts, to identify the images findings that could be related to inflammation of the gallbladder or bile flow obstruction.

Magnetic resonance cholangiopancreatography (MRCP): MRCP is an MRI examination which produces detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It is the most potent of the imaging examinations for biliary anomalies (relative to bile) and can identify gallstones, inflammation of the gallbladder or bile duct, or biliary system crash. Nuclear hepatobiliary Images: This is a type of diagnostic nuclear medicine imaging that helps assess conditions affecting the liver, gallbladder and ducts that are part of the biliary system

VI.

Treatment

Initially, to reduce inflammation of the gall bladder, the doctor may cholecystitis treated with: fasting, to rest the gallbladder. medications to treat pain. Antibiotics, if an infection. However, because they can avail cholecystitis often the doctor may recommend removal of the gallbladder using: laparoscopic cholecystectomy performed with the patient under anesthesia generally, where the surgeon uses several small incisions navel Abdominal to insert a laparoscope and instruments to view the inside of the abdominal cavity and remove the gallbladder, leaving behind minimal scarring.

open cholecystectomy, performed with the patient under general anesthesia. Gallbladder is removed through an incision in the abdomen. In patients who are high-risk surgical candidates, the doctor may recommend endoscopic retrograde cholangiopancreatography (ERCP), the cholecystotomy percutaneous or percutaneous hepatic cholangiography (PTC).

VII. Bibliografia
http://www.nlm.nih.gov/medlineplus/spanish/ency/article/000264.htm http://unidad-gastroenterologia.com/colecistitis.html http://www.radiologyinfo.org/sp/pdf/cholecystitis.pdf