Chronic cholecystitis

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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[edit | edit source]

  • 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[edit | edit source]

  • Microbial infections, chemical irritation and metabolic causes apply.

Clinical picture[edit | edit source]

  • 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.

Diagnosis[edit | edit source]

Anamnesis[edit | edit source]

Physical examination[edit | edit source]

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

Further examination[edit | edit source]

  • 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[edit | edit source]

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

Therapy[edit | edit source]

  • 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.

Links[edit | edit source]

Related articles[edit | edit source]

External links[edit | edit source]

Source[edit | edit source]

Použitá literatura[edit | edit source]

Kategorie:Vložené články Kategorie:Chirurgie Kategorie:Vnitřní lékařství Kategorie:Gastroenterologie Kategorie:Patologie