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Pathophysiology of case

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  • 1. Predisposing Factors: Female gender Fat / Obese Fertile Fair complexion Middle Age / 40 years old and up) American Indian ancestry / Native American Multigravid / multiparous woman Gallbladder, pancreatic, ileal or GI diseases Precipitating Factors: High Cholesterol Diet Use of oral contraceptive pills Frequent changes in weight Estrogen Therapy Increase cholesterol excretion in liver Gallbladder sludgePregnancy, starvation, and rapid weight loss Thickened gallbladder mucoprotein with tiny trapped cholesterol crystals Supersaturation of cholesterol crystal or microstones Macrostone formation Increased motility of gallbladder Obstruction in bile ducts Bile absorbed by the blood Gallbladder becomes distended and inflamed Increased level of conjugated bilirubin which binds with calcium Pigmented stones form Jaundice Dark colored urine Grayish feces Absces Necrosis Perforation Peritonitis Fever Biliary colic Abdominal mass Pain Cholelithiasis
  • 2. Pathophysiology (Book) References: Huether, Sue E., McCance, Kathryn L. (2000). Understanding Pathophysiology (2nd ed.). Singapore: Mosby, Inc. Porth, Carol Mattson. (2007). Essentials of Pathophysiology: Concepts of Altered Health States (2nd ed.). Lippincott Williams and Wilkins. Smeltzer, Suzanne C., et al. (2010). Brunner and Suddarth’s Textbook of MedicalSurgical Nursing (12th ed.). Wolters Kluwer Health/ Lippincott Williams and Wilkins. Evaluation and Comparison (PATHO) The patient is female, fat that weighs 90 kg, fertile in the age of 39, has fair complexion and has a family history of Diabetes Mellitus. Other than that, she prefers to eat fatty foods and drinks cola’s and juices other than water, she also uses oral contraceptive pills. According to the book these factors may predispose and precipitate the patient in acquiring Cholelithiasis. The patient has abdominal pain prior to admission felt on the URQ and on the epigastric area while being palpated. According to the book, as the patient feels abdominal pain on the URQ and epigastric area these means that he/she has obstructed or inflamed gallbladder. These was proven and supported by the seen calculi in the lumen of her gallbladder through HBT/ Pancreatic Ultrasound.
  • 3. Increase Estrogen in the body Decreased Cholecystokinin function Increase Estrogen in the body Predisposing Factors: Female Fat ( the patient weighs 90 kg) Fertile (the patient is 39yrs.old) Fair complexion Increase cholesterol intake Precipitating Factors: Fatty food diet Use of oral contraceptive pillsIncrease Estrogen in the body Superaturation of cholesterol crystal Increase cholesterol excretion in liver Gallstone formation Obstruction in the bile ducts Gallbladder become inflamed Abdominal pain in the upper right quadrant Cholecystolithiasis