University:
Stanford University
Course:
MED 101 | Human Anatomy
Academic year:

2023
Views:

28

Pages:

2
Author:

larbi43100

‭Acute cholecystitis‬ ‭It is the consequence of the sudden obstruction of the cystic duct by lithiasis:‬ ‭-‬ ‭ linical signs: they are identical to those of hepatic colic, but‬ c ‭persist longer and are accompanied by fever or sometimes‬ ‭hypothermia. Vomiting is almost constantly present;‬ ‭-‬ ‭ iological signs: there is hyperleukocytosis, the liver function tests‬ b ‭being normal or discreetly modified;‬ ‭-‬ i‭maging methods: the first-line examination is ultrasound which allows‬ ‭us to see the stone blocked in the cystic duct, as well as the vesicular‬ ‭distension and the thickening of its wall (> 3 mm). We also find an‬ ‭ultrasound Murphy's sign (passing the probe over the right‬ ‭hypochondrium causes a Murphy's sign as described in hepatic colic).‬ ‭Chronic cholecystitis‬‭-It is the consequence of incomplete‬‭or intermittent‬ ‭obstruction of the cystic duct by lithiasis. A particular form deserves‬ ‭mention: the porcelain vesicle (so named because its wall is the site of‬ ‭abundant calcium deposits) whose risk of malignant transformation is high‬ ‭(20 to 60%).‬ ‭Gallbladder cancer‬‭-It is only expressed clinically‬‭after invasion of neighboring‬ ‭organs (liver, duodenum, colon, hepatic pedicle). Affecting women more than‬ ‭men (sex ratio = 4/1), it has a very poor prognosis when diagnosed at an‬ ‭advanced stage (6 months survival on average).‬ ‭Case of alithiatic cholecystitis‬‭-5 to 10% of alithiatic‬‭cholecystitis is not‬ ‭caused by an obstructive stone mechanism. Although the factors favoring this‬ ‭type of cholecystitis are numerous (see table below), the etiology remains‬ ‭unknown in more than half of the cases.‬ ‭Factors favoring alithiatic cholecystitis‬ ‭-‬ ‭Postpartum after prolonged labor‬ ‭-‬ ‭After abdominal or orthopedic surgery‬ ‭-‬ ‭Vasculitis‬ ‭-‬ ‭Obstructive gallbladder adenocarcinoma‬ ‭-‬ ‭Diabetes‬ ‭-‬ ‭Gallbladder volvulus‬ ‭-‬ ‭Leptospira vesicular infection‬ ‭-‬ ‭Bile duct parasitosis‬ ‭-‬ ‭Sarcoidosis‬ ‭-‬ ‭Tuberculosis‬ ‭-‬ ‭Syphilis‬ ‭-‬ ‭Actinomycosis‬ ‭-‬ ‭Prolonged parenteral nutrition‬