Chronic cholecystitis

thumb|250px|Chronická rekurentní cholecystitida thumb|250px|Cholecystolitiáza na ultrasonografii thumb|250px|Cholecystolitiáza
 * It occurs either by gradual development or is the result of acute cholecystitis once or repeatedly,
 * each attack of cholecystitis increases the risk of life-threatening complications.

Pathological finding

 * Wall fibrosis with inflammatory exudation, the wall is thickened, stiffer, the mucosa is red, sometimes covered with ulcers, sometimes completely absent,
 * retraction occurs with longer duration → a picture of a wrinkled gallbladder,
 * in cystic obstruction → hydrops – bile discolors after absorption of bile pigments, calcium salts fall out and give the gallbladder a milky color,
 * salts can also be deposited in the wall → „porcelain gallbladder“.

Etiology

 * Microbial infections, chemical irritation and metabolic causes apply.

Clinical picture

 * It corresponds to the difficulties arising from lithiasis,
 * biliary dyspepsia – abdominal pressure, episodic local or diffuse abdominal pain, heartburn, anorexia, flatulence, nausea, steatorrhea,
 * attacks of repeated biliary colic.

Anamnesis

 * Cholelithiasis,
 * repeated attacks of biliary colic, past acute cholecystitis.
 * dyspeptic problems

Physical examination

 * It usually does not contribute to the diagnosis,
 * in the case of an acute exacerbation, Murphy's sign may be positive.

Further examination

 * Increased sedimentation and leukocytosis in gallbladder empyema,
 * the basic examination is USG,
 * X-ray – pathological finding on the gallbladder – loss of function, reduced concentration and evacuation ability.

Complication

 * Mainly acute exacerbations, cholangitis with hepatic parenchyma, formation of biliodigestive fistulas, development of liver or subfrenic abscess, which may cause pancreatitis.

Therapy

 * Conservative - pain control, anticholinergics, antispasmodics, infection prevention, adjustment of water and electrolyte balance, stomach decompression as needed, pancreatic enzyme replacement as needed, possibly. vitamins,
 * causal treatment is only surgery → cholecystectomy,
 * Neither baths nor antibiotics stop the process on the gallbladder.

Related articles

 * Acute cholecystitis
 * Infectious cholangitis