Name
ACALCULOUS CHOLECYSTITIS
DESCRIPTION
DETAIL
- A SEVERE ILLNESS THAT IS COMPLICATION OF VARIOUS OTHER MEDICAL OR SURGICAL COMPLICATIONS WHICH CAUSES : - GALLBLADDER STASIS WITH RESULTANT STAGNANT BILE IN * PTS WITH SEPSIS * PTS IN ICU * PTS ON LONGTERM TPN * PTS WITH DIABETES -------------------------------------------------------------------------- D.D. : - BILE DUCT STRICTURES - BILIARY COLIC - BILIARY DISEASE - BILIARY OBSTRUCTION - CHOLECYSTITIS - CHOLEDOCHOLITHIASIS - CHOLELITHIASIS - DUODENAL ULCER - GALL BLADDER CANCER - GASTRIC ULCER - GASTRITIS, ACUTE - GASTRITIS, CHRONIC - HELICOBACTER PYLORI INFECTION - HEPATITIS, VIRAL - IRRITABLE BOWEL SYNDROME - PANCREATITIS, ACUTE - PANCREATITIS, CHRONIC* BLOOD CULTURE - MAY BE STERILE DUE TO ANTIBIOTIC USE * LIVER FUNCTION TEST - MAY BE ABNORMAL DUE TO CHOLESTASIS * CT ABDOMEN - ENLARGED , THICK WALLED GALLBLADDER
TYPENOTES
Medical Care: When the diagnosis of acalculous cholecystitis is established, immediate intervention is indicated because of the high risk of rapid deterioration and gallbladder perforation. In patients with acalculous cholecystitis who are high-risk surgical candidates (ie, end-stage liver disease), endoscopic gallbladder stent placement has been reported as an effective palliative treatment. This involves placement of a double pigtail stent between the gallbladder and the duodenum during endoscopic retrograde cholangiopancreatography (ERCP). However, the definitive treatment of acalculous cholecystitis is cholecystectomy for patients who are able to tolerate surgery. Surgical Care: In surgical candidates, open or laparoscopic cholecystectomy is indicated. In patients who are not surgical candidates, percutaneous cholecystostomy may be performed in the radiology suite. Catheters are usually removed after approximately 3 weeks in critically ill patients with acalculous cholecystitis who have undergone percutaneous cholecystostomy. This allows for the development of a mature track from the skin to the gallbladder. Diet: Patients in the acute stage of acalculous cholecystitis should receive nothing by mouth. Provide hydration with intravenous fluids. Administer broad-spectrum antibiotics for enteric and biliary pathogen coverage. Definitive treatment is cholecystectomy in patients who are surgical candidates.
RELATED DISEASE
Not Available Disease
DISEASE
INVESTIGATION
ULTRA SOUND WHOLE ABDOMEN - FEMALE, COMPLETE BLOOD COUNT, CT SCAN ABDOMEN, LIVER FUNCTION TEST