Acute cholecystitis is an acute inflammation of the gallbladder walls, which occurs when the outflow of bile is violated and, as a consequence, the development of bacterial infection. This disease refers to requiring surgical intervention and after appendicitis is the second most frequent case.
Obvious symptoms of acute cholecystitis
The main symptom in an attack of acute cholecystitis is biliary colic. With her there is a sharp pain in the right hypochondrium, which can give to the right shoulder, scapula, subclavian area. The pain is accompanied by nausea and vomiting, in which a bitter taste develops in the mouth, and bile is noticeable in the vomit. At first the pain is cramping, but over time it becomes more and more intense and, often, continuous.
In addition to colic, with acute cholecystitis, symptoms are characteristic of infectious diseases in general:
- body temperature elevated (from subfebrile to high);
- chills may occur;
- tongue dry and covered;
- the pulse is usually rapid;
- arterial pressure decreased.
In cases where there is blockage of the bile duct, jaundice may occur, although with acute cholecystitis such a symptom is rarely observed.
The specific signs of acute cholecystitis include:
- symptom Grekov-Ortner (soreness when tapping the right costal arch with the palm of the hand);
- pain during palpation in the right upper quadrant intensifying when inhaled;
- a symptom of Murphy (with a deep palpation, the patient can not breathe).
Forms of acute cholecystitis
Depending on the cause that caused the disease, cholecystitis is divided into calculous and tubeless. Most often there is acute calculous cholecystitis, which arises from the obstruction of the bile ducts with stones in cholelithiasis. The stoneless form of the disease is from 5 to 10% of the total number of cases and can be caused by infectious diseases, gastrointestinal diseases, giardiasis and other causes. In acute calculous cholecystitis, symptoms are usually more pronounced, and it requires mandatory surgical intervention, whereas the stoneless form of the disease proceeds in a lighter form and can sometimes be treated with conservative methods.
Depending on the overall clinical picture and the severity of the course, acute cholecystitis is divided into the following forms:
- Catarrhal cholecystitis is the easiest form, sometimes mistaken for colic attacks. It is accompanied by moderate pain, nausea, rarely vomiting.
- Phlegmonous cholecystitis - pains are pronounced, intensified by changing the position of the body, the temperature rises to 38 ° C, the pulse is rapid, the stomach can swell, the level of leukocytes in the blood is increased.
- Gangrenous cholecystitis occurs with the progression of the lighter forms of the disease. The symptoms of general inflammation come to the fore. The inflammatory process extends beyond the gallbladder. The temperature is high, pain can decrease due to necrosis of gallbladder tissues, pronounced tachycardia, signs of general intoxication.
Complications of acute cholecystitis
The most dangerous complication of acute cholecystitis is perforation (rupture) of the gallbladder with the ingress of its contents into the abdominal cavity, which leads to the development of peritonitis. In the presence of
In the case of suppression of infection with preserved blockage of the bile ducts, in some cases gall bladder edema occurs. It can take a long time without causing any particular discomfort, but it is also fraught with a threat of rupture and the development of peritonitis.
All complications develop in case of untimely treatment of acute cholecystitis.