CHOLECYSTITIS Prepared by: Dairbekov Alisher
Cholecystitis - chronic inflammation of the gallbladder. The disease is common and is more common in women.
CAUSES OF CHOLECYSTITIS Bacterial flora (Escherichia coli, streptococci, staphylococci, and others), in rare cases - anaerobes, worm infestation (roundworm) and fungal infection (actinomycosis), hepatitis viruses, there cholecystitis toxic and allergic nature. The penetration of the microbial flora in the gallbladder is enterogenous, hematogenous or lymphatic route.
Predisposing factor of cholecystitis is the stagnation of bile in the gall bladder, which can cause gallstones, compression of the bile ducts and excesses, dyskinesia of the gallbladder and biliary tract, disturbances of tone and motor function of the biliary tract in response to various emotional stress, endocrine and autonomic disorders, reflexes of pathological changes of the digestive system. Stagnation of bile in the gall bladder also contribute omission viscera, pregnancy, lack of exercise, occasional meals, etc. , is also of importance in pancreatic juice reflux biliary dyskinesia when its proteolytic action on the mucous membrane of the bile ducts and gall bladder. The immediate cause of an outbreak of the inflammatory process in the gallbladder often overeating, especially reception is very fatty and spicy foods, drinking alcohol, acute inflammation in other organs (tonsillitis, pneumonia, adnexitis, etc. ). Chronic cholecystitis can occur after acute, but usually develops gradually and independently, against gallstones, gastritis with secretory insufficiency, chronic pancreatitis and other diseases of the digestive system and obesity.
SYMPTOMS OF CHOLECYSTITIS Cholecystitis characterized by a dull, aching pain in the right hypochondrium, either permanently or occurring 1 -3 hours after consumption of abundant and especially fatty and fried foods. Pain radiating up into the area of the right shoulder and neck, right scapula. May occasionally occur sharp pain resembling biliary colic. Frequent dyspeptic symptoms: a feeling of bitterness and metallic taste in the mouth, burping air, nausea, bloating, impaired bowel movements (often alternating constipation and diarrhea), and irritability, and insomnia. Jaundice is not typical. On palpation the abdomen, usually depends on the sensitivity and sometimes severe pain in the projection of the gall bladder to the anterior abdominal wall and the light resistance of the abdominal wall muscle (resistance). Part of the positive symptoms of Musso - George, Ortner, Obraztsova - Murphy.
Liver increased slightly with plotnovatym and tenderness edge of complications of chronic cholecystitis (chronic hepatitis, cholangitis). Gall bladder in most cases is not palpable, as he usually wrinkled due to chronic scar-sclerosing process. Acute exacerbations of cholecystitis observed neutrophilic leukocytosis, increased erythrocyte sedimentation rate and temperature reaction. When duodenal intubation is often impossible to get a portion of the gallbladder into the bile (due to violation of concentrating ability of the gallbladder and cystic disorders reflex) or this portion
bile has a few darker than A and C, often turbid. Microscopic examination of the duodenal contents revealed a large amount of mucus, desquamated epithelial cells, "WBC", particularly in portions of bile (the discovery of "white blood cells" in the bile not attach such significance as before, as a rule, they are decaying nuclei of duodenal epithelial cells). Bacteriological study of bile (especially recurrent) to determine the causative agent of cholecystitis. When cholecystography marked change in the shape of the gallbladder, it is often the image is blurred due to violation of concentration ability of the mucosa, sometimes you see a stone. After receiving the stimulus - holetsistokinetika (usually two egg yolks) - there is insufficient reduction of the gallbladder. Symptoms of chronic cholecystitis defined and ultrasound (as a thickening of the walls of the bladder, strain it, and so on).
THE DISEASE During most of the long-term, is characterized by alternating periods of remission and exacerbation, the latter often result from eating disorders, drinking alcohol, heavy physical work, addition of acute intestinal infections, hypothermia. Prognosis in most cases favorable. Impairment cholecystitis patients and temporary loss of their ability to work - only for periods of flareup. Depending on the characteristics of a release of latent (sluggish), the most common - recurrent, chronic ulcerous forms of chronic cholecystitis. Complications of chronic cholangitis accession, hepatitis, pancreatitis. Often the inflammatory process is a "push" to the formation of stones in the gallbladder. Differentiate from chronic cholecystitis, cholelithiasis (two diseases are often combined), chronic cholangitis. Primary importance are data cholecysto holegrafii and especially to avoid repeated gallstones, and sonography.
PREVENTION OF DISEASE Prevention of chronic cholecystitis is in compliance with diet, exercise, obesity prevention, treatment of focal infection.
TREATMENT OF CHOLECYSTITIS Acute exacerbations of chronic cholecystitis patients admitted to a surgical or therapeutic hospital and being treated there. Mild cases may outpatient treatment. Prescribe bed rest, diet, eating 4 -6 times a day, antibiotics. Assign also sulfa drugs. During the inflammation subsided, you can assign thermal physiotherapy
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