Cholecystitis

What is cholecystitis, what are its causes, symptoms and treatment.

Cholecystitis - an inflammation of the gallbladder.There are acute and chronic cholecystitis.Chronic is different from acute long-term development, with alternating exacerbations and remissions, when the anxiety on the part of the bladder completely marked.

If during the survey reliably detected gallstones in the gallbladder lumen, so called calculous cholecystitis.This is a manifestation of cholecystitis cholelithiasis.But not always, caused by inflammation of the gall bladder stone formation.Not rare cases when an extremely pronounced manifestations of inflammation, purulent lesions until the bubble walls, stones (calculi) and do not show, even during open surgery.

reasons

believed that provoking factors are irregular meals, abuse of fat and fried food.If irregular eating can contribute to stagnation of bile in the bladder, the meats and fatty meats can cause bladder over-voltage up to spasms.Violation of the outflow from the g

allbladder, in addition to stone, may also be caused by obesity or pregnancy.Primary impaired ability to dispose of bladder bile duct (dyskinesia) theoretically increases the risk of falling ill.By the way, the diagnosis of gallbladder dyskinesia love unnecessarily expose the children in an attempt to explain the vague pain in the right upper quadrant.The diagnosis of this move is used in children's polyclinics only on the basis of ultrasound of the abdomen, and sometimes without it.And, meanwhile, the contractile activity of the gall bladder in the US is not defined at all.Data on bladder function can only be obtained with the help of contrast radiography, which is performed in hospitals, in particular indications and very infrequently.

Signs

The most common symptom of gallbladder inflammation is pain.Usually the pain aching, medium intensity, concentrated in the right upper quadrant.The pain may be given to the right collarbone, right shoulder blade, but this feature is not clearly defined.Suggest a gallbladder inflammation may link such pain with eating.Pain can manifest itself somewhere within an hour after a meal, especially if you eat greasy, fried and smoked food.Provoking products may be chocolate, soda, spices, eggs, turnips, onions, butter, ice cream, coffee and sour berries.These products, as well as some others, are eliminated from the diet in order to avoid exacerbation of the disease.This diet is called hepatic or table №5.

Other symptoms so characteristic: bloating, symptoms of indigestion, heartburn, irritability.They can be mistaken for symptoms of gastroduodenitis and even stomach ulcers.

If pain attacks are very intense, they are called biliary colic.A distinctive feature of biliary colic, usually caused by gallstones, is a dramatic relief after receiving the injection or antispasmodics.That spasm of the gall bladder - or rather, his neck, is considered to be the cause of such pain.Against the background of cervical spasm or blockage of the gall bladder stones unsuccessfully trying to empty that even more irritating its walls.Due to the onset of inflammation to the bile in the gallbladder lumen begins admixed with inflammatory exudate, aggravating tension and irritation of the walls.Patients modest fatness may be found in the right upper quadrant crowded and stretched the gallbladder, but generally patients are prone to a fair amount of the thickness of subcutaneous fat.

Diagnostics

Cholecystitis definitively diagnosed by ultrasound.Ultrasound can not only detect gallstones, if they are, but the degree of change to determine the bladder wall, and hence reveal inflammation even estimate the stage and duration of the disease.Of course, the diagnosis is made in conjunction with other diagnostic methods (and biochemical blood test, urinalysis, etc.), but the ultrasound data are critical.Collecting bile portions, still nobody canceled, now rarely used, and only for special reasons.

Treatment

Gallbladder, disgraced himself by his regular bouts of colic, and is a candidate for deletion.Even if in the lumen of the inflamed bladder stones were found, changes in the mucous can cause their formation.And inflammation of the bladder is able to move quickly in the purulent stage (phlegmonous cholecystitis), the development of a dangerous inflammation of the peritoneum (peritonitis).Peritonitis is dangerous to life, so to prevent his gall bladder removed surgically.Classical open cholecystectomy (gall bladder removal) allows for quality inspection and audit of the status of not only the bladder but also ducts.Although this operation is very traumatic and requires an extended recovery.
Therefore, as a better alternative, has long been implemented and put on stream laparoscopic surgery performed without incisions, through punctures in the abdominal wall.This method of removing the gallbladder in all developed countries is the "gold" standard for the treatment of calculous cholecystitis.The patient may have to leave the hospital 2 hours, the abdominal wall is not damaged wide incision.

But this operation is only possible in the absence of complications (obstruction of the bile duct, peritonitis, gangrene of the gallbladder).

Needless removal of the gallbladder does not significantly affect digestion.Bile continues to flow into the intestine and take part in the digestion of fats.But it ceases to be accumulated before eating, because the gall bladder is on the function, storage of bile.Less bladder removal lead to complex complaints, called "postcholecystectomical syndrome" (PHES).

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