EXPLAINING OF ACALCULAR CHOLECYSTITIS

EXPLAINING OF ACALCULAR CHOLECYSTITIS

Acalcular or non calcular cholecystitis

Definition
It is mean acute or chronic inflammation of the gall bladder due to other causes rather than gall stones
  Acalculous cholecystitis typically develops in critically ill patient in the intensive care unit
 explaining of aclcular cholecystitis
gall bladder anatomy
 Risk factors are
  • Patients on parenteral nutrition with severe burns
  • sepsis
  •  major operations
  • multiple trauma
  • prolonged illness with multiple organ system failure 
    The cause is unknown, but gall bladder distention with bile stasis and ischemia have been implicated as causative factors

Pathologic examination of the gallbladder

reveals edema of the serosa and muscular layers, with patchy thrombosis of arterioles and venules
Other causes of non calcular cholecystitis
Bacterial infection Typhoid gall bladder Salmonella typhi can infected the gall bladder leading to acute or chronic cholecystitis Biliary dyskinesia which due to achalasia or dilatation of the sphincter of Oddi leading to marked dilatation of the fall bladder The cholecystoses which include the following conditions Cholesterosis or called also Strawberry gall bladder this is due to an error in cholesterol metabolism which causes deposition of cholesterol crystals in the mucosa of the gall bladder which become red and studded with yellow specks of cholesterol esters giving strawberry appearance later on forming lipoid polpi called cholesterol polyposis of the gall bladder and ending in cholesterol stone formation Cholecystic Glandularis Proliferans which include a varieties of conditions affecting the gall bladder by polps adenomyomatosis intramural or diverticular stones which can be complicated by an intra or extra mural abscess and fistua form

المصدر : http://best-medical-surgical.blogspot.com/2014/01/chronic-cholecystitis-causes-treatment.html#.UtjP-85b7XQ
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Bacterial infection Typhoid gall bladder Salmonella typhi can infected the gall bladder leading to acute or chronic cholecystitis Biliary dyskinesia which due to achalasia or dilatation of the sphincter of Oddi leading to marked dilatation of the fall bladder The cholecystoses which include the following conditions Cholesterosis or called also Strawberry gall bladder this is due to an error in cholesterol metabolism which causes deposition of cholesterol crystals in the mucosa of the gall bladder which become red and studded with yellow specks of cholesterol esters giving strawberry appearance later on forming lipoid polpi called cholesterol polyposis of the gall bladder and ending in cholesterol stone formation Cholecystic Glandularis Proliferans which include a varieties of conditions affecting the gall bladder by polps adenomyomatosis intramural or diverticular stones which can be complicated by an intra or extra mural abscess and fistua form

المصدر : http://best-medical-surgical.blogspot.com/2014/01/chronic-cholecystitis-causes-treatment.html#.UtjP-85b7XQ
Content Copyrighted to Hobby to Money
Bacterial infection Typhoid gall bladder Salmonella typhi can infected the gall bladder leading to acute or chronic cholecystitis Biliary dyskinesia which due to achalasia or dilatation of the sphincter of Oddi leading to marked dilatation of the fall bladder The cholecystoses which include the following conditions Cholesterosis or called also Strawberry gall bladder this is due to an error in cholesterol metabolism which causes deposition of cholesterol crystals in the mucosa of the gall bladder which become red and studded with yellow specks of cholesterol esters giving strawberry appearance later on forming lipoid polpi called cholesterol polyposis of the gall bladder and ending in cholesterol stone formation Cholecystic Glandularis Proliferans which include a varieties of conditions affecting the gall bladder by polps adenomyomatosis intramural or diverticular stones which can be complicated by an intra or extra mural abscess and fistua form

المصدر : http://best-medical-surgical.blogspot.com/2014/01/chronic-cholecystitis-causes-treatment.html#.UtjP-85b7XQ
Content Copyrighted to Hobby to Money
Bacterial infection Typhoid gall bladder Salmonella typhi can infected the gall bladder leading to acute or chronic cholecystitis Biliary dyskinesia which due to achalasia or dilatation of the sphincter of Oddi leading to marked dilatation of the fall bladder The cholecystoses which include the following conditions Cholesterosis or called also Strawberry gall bladder this is due to an error in cholesterol metabolism which causes deposition of cholesterol crystals in the mucosa of the gall bladder which become red and studded with yellow specks of cholesterol esters giving strawberry appearance later on forming lipoid polpi called cholesterol polyposis of the gall bladder and ending in cholesterol stone formation Cholecystic Glandularis Proliferans which include a varieties of conditions affecting the gall bladder by polps adenomyomatosis intramural or diverticular stones which can be complicated by an intra or extra mural abscess and fistua form

المصدر : http://best-medical-surgical.blogspot.com/2014/01/chronic-cholecystitis-causes-treatment.html#.UtjP-85b7XQ
Content Copyrighted to Hobby to Money
Bacterial infection Typhoid gall bladder Salmonella typhi can infected the gall bladder leading to acute or chronic cholecystitis Biliary dyskinesia which due to achalasia or dilatation of the sphincter of Oddi leading to marked dilatation of the fall bladder The cholecystoses which include the following conditions Cholesterosis or called also Strawberry gall bladder this is due to an error in cholesterol metabolism which causes deposition of cholesterol crystals in the mucosa of the gall bladder which become red and studded with yellow specks of cholesterol esters giving strawberry appearance later on forming lipoid polpi called cholesterol polyposis of the gall bladder and ending in cholesterol stone formation Cholecystic Glandularis Proliferans which include a varieties of conditions affecting the gall bladder by polps adenomyomatosis intramural or diverticular stones which can be complicated by an intra or extra mural abscess and fistua form

المصدر : http://best-medical-surgical.blogspot.com/2014/01/chronic-cholecystitis-causes-treatment.html#.UtjP-85b7XQ
Content Copyrighted to Hobby to Money
  • Bacterial infection Typhoid gall bladder Salmonella typhi can infected the gall bladder leading to acute or chronic cholecystitis 
  • Biliary dyskinesia which due to achalasia or dilatation of the sphincter of Oddi leading to marked dilatation of the fall bladder
  • The cholecystoses which include the following conditions
  • Cholesterosis or called also Strawberry gall bladder this is due to an error in cholesterol metabolism which causes deposition of cholesterol crystals in the mucosa of the gall bladder which become red and studded with yellow specks of cholesterol esters giving strawberry appearance  later on forming lipoid polpi called cholesterol polyposis of the gall bladder and ending in cholesterol stone formation
  • Cholecystic Glandularis Proliferans which include a varieties of conditions affecting the gall bladder by polyps adenomyomatosis intramural or diverticular stones which can be complicated by an intra or extra mural abscess and fistula formation
symptoms and signs
  •   The symptoms and signs depend on the condition of the patient
  •   in the alert patient they are similar to acute calcular cholecystitis see here
  • with right upper quadrant pain and tenderness, fever
  •    in full blood count reveal leukocytosis 
  •  In the sedated or unconscious patient the clinical features are often masked
  •    presence of fever and elevated white blood cell count, as well as elevation of alkaline phosphatase and bilirubin are indications for further investigation
Investigations

Abdominal ultrasonography

Ultrasonography is usually the diagnostic test of choice
as it can be done bedside in the intensive care unit
 It can demonstrate the distended gallbladder with thickened wall, biliary sludge, peri­cholecystic fluid, and the presence or absence of abscess formation
Abdominal CT
 
 Abdominal CT scan is as sensitive as ultrasonography and additionally allows imaging of the abdominal cavity and chest
HIDA scan
A HIDA scan will not visualize the gallbladder
MRI scanning
 
 very good for diagnosis

Cholecystokinin cholecystogtaphy
 
To diagnosis acalculous cholecystitis and biliary dyskinesia

Oral cholecystography


  But rare used nowadays and it is replaced by ultrasound
Treatment
Acalculous cholecystitis quires urgent intervention
 Percutaneous ultrasound or CT-guided cholecystostomy is the treatment of choice for these patients they are usually unfit for surgery 
   percutaneous cholecystostomy is both diagnostic and therapeutic
 
 About 90% of patients will improve with the percutaneous cholecystostomy
 if they do not improve
  open cholecystostomy or cholecystectomy, may required

 If needed, cholecytectomy is performed after the patient
has recovered from the underlying disease

See more http://healthhomeup.com/chronic-cholecystitis-causes-diagnosis-treatment/ 

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tags:acalcular,explaining,cholecystitis

1 comment:

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