Cholecystitis

Chronic cholecystitis with cholelithiasis


Rushed to the male surgical ward right after a boring lecture on bedside manners and decorum. Haih. The environment has forced me to become 'kiasu' these days. I can't help it. I just want to survivie.

Found a case on cholecystitis (inflammation of the gall bladder) caused by cholelithiasis.

Acute cholecystitis follows stone or sludge impaction in the neck of the gall bladder (GB), which may cause continuous epigastric or RUQ pain referred to the right shoulder, vomiting, fever, local peritonism or a GB mass. If the stone moves to the common bile duct, obstructive jaundice and cholangitis may occur.

I was able to palpate a mass in the epigastrium of this particular patient. Tried to elicit the Murphy's sign too. I laid 2 fingers over his RUQ, asked him to take a breath, which I knew would cause pain and arrest of inspiration as his inflammed GB impinged on my fingers. Well, his face did crumple up. Yet, I wasn't sure if what I saw was a Murphy's sign.

Gallstones are the notorius cause acute and chronic cholecystitis. Other complications of gallstones in the GB include biliary colic ( occurs when gallstones become symptomatic with cystic duct obstruction or by passing into the common bile duct), empyema, mucocoele and carcinoma. Whereas, gallstones located in the bile ducts may lead to obstructive (acholuric) jaundice, pancreatitis and cholangitis.