Acute Cholecystitis

Question 1

What is the most common cause of acute cholecystitis?

Answer 1

Gall stones getting stuck in the neck of the gallbladder, cystic duct or common bile

Question 2

How do gallstones lead to cholecystitis?

Answer 2

Stasis of bile and therefore allows bacteria to proliferate? - look up exact cause

Question 3

What are the symptoms of acute cholecystitis?

Answer 3

• Epigastric/RUQ pain (biliary colic)
• Vomiting
• Fever
• Enlarged/shrunken GB
• Jaundice depending on site of impaction

Question 4

What are the signs of cholecystitis?

Answer 4

Murphy’s sign

• Lay 2 fingers over RUQ
• Ask patient to breathe in deeply
• As gallbladder descends with respiration and touches your fingers, respiration is arrested with pain
• Only considered a positive sign if there is no left sided pain

Question 5

Tests for acute cholecystitis?

Answer 5

• USS
• Look for a thick walled gallbladder that may contain multiple stones
• ERCP
• MRCP

Question 6

Surgical treatment?

Answer 6

Cholecystectomy

Question 7

Pharmacological treatment?

Answer 7

Pain relief
Antibiotics
- Cefuroxime

Question 8

What are the complications of acute cholecystitis?

Answer 8

• Pancreatitis main one

- Cholangitis