Acute cholecystitis – treatment of disease. Symptoms and prevention of the disease acute cholecystitis

Острый холецистит – что это за болезнь? Acute cholecystitis is a non-specific inflammatory process, growing in the walls of the gallbladder, most often due to violation of the passage of bile (that is, its outflow).

In the vast majority of (to 95% cases) acute cholecystitis develops as a complication of cholelithiasis and in 60% cases have bacterial origin. This disease often suffer from women (in 3 times more often than men). In the structure of acute surgical pathology of the abdomen acute cholecystitis is about 15%.

Острый холецистит – Причины возникновения

The causes of acute cholecystitis include the following:

• damage to the walls of the gallbladder stones, as well as the obstruction of the ducts (kal'kuljoznyj cholecystitis, cholelithiasis);
• damage to the walls of the gallbladder stones (bacterial cholecystitis, caused by Streptococcus mutans, staphylococci, klebsiellami, clostridia, e. coli or other pathogens);
• damage to the walls of the gallbladder stones, that is the pathological type of enzymes, produced by the pancreas, in gall bladder;
• damage to the walls of the gallbladder stones (When strikture Terminal bile duct, small one-offs and holecistoholangity);
• damage to the walls of the gallbladder stones (diet in the form of overeating, a large amount of spicy and fatty foods in the diet);
• Other diseases of the digestive system (chronic antral gastritis and gipoacidnyj gastritis due to the increased likelihood of penetration of pathogenic flora in the gall bladder in conditions ahilii);
• Other diseases of the digestive system;
• Other diseases of the digestive system;
• Other diseases of the digestive system (in Systemic Lupus Erythematosus, uzelkovom periarteriite, etc.);
• severe conditions, including shock (major operations, burns, sepsis).

Symptoms of acute cholecystitis

The main clinical feature of acute cholecystitis-acute Biliary colic is intense pain in the right hypochondrium, epigastrium, irradiirujushhaja under shoulder blade, in right shoulder, collarbone. Attack bile colic often occurs against the backdrop of errors in diet, that is, after consuming large quantities of oily, spicy food, alcohol, or against the background of strong emotional stress. Also typical of the appearance of nausea, bitter taste in the mouth and vomiting with admixtures of bile. May increase body temperature (more often to subfebril'nyh numbers). When the obstruction of the common bile duct may cause ikterichnosti (zheltushnosti) scleras and skin. Language in this dry, hedged.

Острый холецистит – Диагностика

When inspecting the gastrojenterologom identify specific positive (patognomonichnye) symptoms of Kera (pain in the right podreberie at deep palpation), Grekova-Ortner (soreness in the right podreberie, with pokolachivanii on the right rib arc Palm edge), Murphy (the inability to breath at deep palpation in the right podreberie due to pain), Obraztsova (by palpation for inhaling pain increases) and George-Mussy (painful palpation in the field right sternocleidomastoid muscle).

Methods of laboratory and instrumental Diagnostics, used in acute cholecystitis:

• severe conditions (nonspecific signs of inflammation are increased ESR, Leukocytosis with left shift);
• physical examination (bilirubinemia, desproteinemia, increase in liver transaminases, amilazы);
• severe conditions (Double contours and thickening of the wall of the gallbladder, voltage bubble under ULTRASONIC sensor, as well as the possible expansion of the bile ducts);
• severe conditions (for differential diagnosis in complex cases);
• severe conditions (a detailed study of biliary ERCP endoscopic method).

Острый холецистит – Классификация

Acute cholecystitis are classified as follows::

• acute calculous cholecystitis (85-95% cases);
• acute calculous cholecystitis (acalculous) cholecystitis.

By the nature of the inflammatory process emit kataral'nuju and destructive (purulent) forms of acute cholecystitis. Latest, in turn, can be flegmonoznoj, flegmonozno-peptic ulcer, Pyoderma and its depending on the stage of the inflammatory process flow.

Острый холецистит – Действия пациента

If you experience symptoms, similar to above, It is recommended that you immediately seek specialized assistance in medical institution.

Treatment of acute cholecystitis

When this disease all patients subject to urgent hospitalization in the surgical hospital. Pre-hospital treatment is administered by spazmoliticescoy mixture (2 ml 2% papaverine hydrochloride, 2 ml 2% No-shpa, 1 ml 0,1% atropine sulfate, 2 ml 0,2% platifillina gidrotartrata). Spend detoxication therapy and antibacterial in case an infected cholecystitis. In severe cases, surgery may be required (holecistotomija, cholecystectomy).

Острый холецистит – Осложнения

Acute cholecystitis in the absence of adequate therapy can turn into chronic, complications may arise in the form of gallbladder perforation, hepatitis, gangrene of the gallbladder, Sepsis, pancreatitis.

Prevention of acute cholecystitis

The basis of prevention cholecystitis is rational nutrition, limit alcohol, as well as moderate exercise.