5. EFFECTS AND COMPLICATIONS OF GALLSTONES In the gall bladder silent stone perforation Ac. Cholecystitis empyema Chr. Cholecystitis mucocele Gangrene carcinoma In the bile duct: obstructive jaundice cholangitis Acute pancreatitis In the intestine: Acute intestinal obstruction [gallstone ileus]
6. CHOLECYSTITIS: It is an inflammatory condition of the gall bladder. 1. Acute 2. Chronic (a) Secondary chronic cholecystitis (b) Primary chronic cholecystitis ACUTE CHOLECYSTITIS: 90% associated calculi PATHOLOGY . Obstruction or stasis . Chemical irritation . Bacterial Infection
7. Clinical features: Dyspeptic symptoms. Right subcostal pain Pyrexia Jaundice Investigation: Routine blood ECG USG(upper abdomen ) X-Ray of the abdomen cholescintigraphy Treatment: conservative treatment followed by cholecystectomy Nasogastric aspiration and IV fluid administration Analgesics Broad spectrum antibiotics surgical treatment: Cholecystectomy
8. Chronic Cholecystitis Two variety: secondary chronic cholecystitis primary chronic cholecystitis Clinical features: vague and insidious in onset Intolerance to fatty food Belching Postcibal epigastric distension Nausea and vomiting. Pain usually follows meal Investigations: Blood routine Oral cholecystography USG Treatment: Cholecystectomy is the definitive treatment
