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PRESENTATION29.pptx
1.
2. Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in
your gallbladder. The gallbladder is a small organ located just beneath the liver. The
gallbladder holds a digestive fluid known as bile that is released into your small
intestine
These gallstones may go on further to develop complications such as cholecystitis,
cholangitis, choledocholithiasis, gallstone pancreatitis, and rarely
cholangiocarcinoma.
Cholelithiasis, or gallstones, are hardened deposits of digestive fluid that form in the
gallbladder. The gallbladder is a small, pear-shaped organ that lies beneath the liver
and stores bile made by the liver. Bile is a digestive fluid made of cholesterol, bile
salts, and bilirubin and gets released into the small intestine through the cystic duct
and common bile duct, to aid in fat digestion. Gallstones can range in size and an
individual may develop several small gallstones, one large gallstone, or a
combination of different sized gallstones. In the United States, roughly 6% of men
and 9% of women have cholelithiasis, most of whom are without symptoms
3.
4. Causes
It's not clear what causes gallstones to form.
• bile contains too much cholesterol. .
• bile contains too much bilirubin.
• gallbladder doesn't empty correctly.
Types of gallstones that can form in the gallbladder include:
Cholesterol gallstones. The most common type of gallstone, called a cholesterol gallstone, often
appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but
may contain other components.
Pigment gallstones. These dark brown or black stones form when your bile contains too much
bilirubin.
5. Risk factors
Factors that may increase your
risk of gallstones include:
Being female
Being age 40 or older
Being overweight or obese
Being pregnant
Eating a high-fat diet
Eating a high-cholesterol diet
Having a family history of
gallstones
Having diabetes
Taking medications that contain
estrogen, such as oral
contraceptives or hormone
therapy drugs
Having liver disease
8. TREATMENT
Surgery to remove the gallbladder (cholecystectomy). Your doctor may
recommend surgery to remove your gallbladder, since gallstones frequently recur.
Once your gallbladder is removed, bile flows directly from your liver into your small
intestine, rather than being stored in your gallbladder.
Medications to dissolve gallstones. Medications you take by mouth may help
dissolve gallstones. But it may take months or years of treatment to dissolve your
gallstones in this way, and gallstones will likely form again if treatment is stopped.
Laparoscopic cholecystectomy
Special surgical tools and a tiny video camera are inserted through incisions in your
abdomen during laparoscopic cholecystectomy. Your abdomen is inflated with
carbon dioxide gas to allow room for the surgeon to work with surgical tools.
11. PROVISIONAL
DIAGNOSIS:CHOLELITHIASIS WITH
SLUGE IN GB
C B P :
O J E C T I V E D ATA :
PARAMETERS RESULT 1 RESULT 2 NORMAL RANGE
HEAMHOGLOBIN 12.1 13.3 13-17
RBC 4.73 5.2 4.5-5.5
WBC 8980 8700 4000-11000
PLATLET 2.52 2.4 1.5-4.5
12. 01 02 03
F I N A L D I A G N O S I S : C H O L E L I T H I A S I S
W I T H S L U G E I N G B
Radio-opaque sludge
noted in the lumen of
gallbladder, with small
radiodense focus of
size 3mmm are noted
within it
CT SCAN
Gallbladder is
distented with
echogenic sludge
ULTRA SOUND
C
C-REACTIVE
PROTIEN
12mg/dl( positive)
13. PARAMETERS RESULT NORMAL RANGE
TOLTAL PROTEIN 7.0 6-7.5
SERUM ALBUMIN 4.1 3.5-5.0
TOTAL BILIRUBIN 0.2 1.4-8.7
SGOT 16 5-45
SGPT 11 5-45
RFT:
SERUM CREATINE-0.3mg/dl
15. DAY NOTES:
DAY NOTES DAY1 DAY2 DAY3 DAY4
C/O Abdominal
pain,vomitigd
No fresh
complaints
No fresh
complaints
No fresh
complaints
O/E Pt isc/c/c pt is c/c/c pt is c/c/c pt is c/c/c/
ADV NBM for 6 hrs,
BT,CT
Pain at
operative place
Urology opinion
Rx Inj.Buscopan,
Inj.zofer,
Inj.Monocef,
Inj.pan
CST CST+metrogyl,d
yanpar,pcm
CST
17. TREATMENT CHART
DOS
AGE
FOR
M
DRUG GENERIC
NAME
DOSE ROU
TE
FR
EQ
UE
NC
Y
DAY
1
DAY
2
DAY3 DAY
4
CATEGORY
Inj MONOCEF CEFTRIAXONE 1g IV BD ✔ ✔ ✔ ✔ ANTIBACTERIAL
Inj METROGYL METRONIDAZO
LE
50mL IV TID ✔ ✔ ✔ ✔ ANTIBIOTICS
Inj PAN PANTAPERAZO
LE
40mg IV OD ✔ ✔ ✔ ✔ PROTON PUMP
INHIBITOR
Inj DYANPAR DICLOFENAC 20mg IV BD ✔ ✔ ✔ ✔ NSAIDS
Inj PCM ACETAMINOPH
EN
500mg IV SO
S
✔ ✔ ✔ ✔ PAIN KILLER
Inj ZOFER ONDANSETRON 2mg IV OD ✔ ✔ ✔ ✔ ANTIEMITIC
Inj BUSCOPAN
IN 100ml NS
HYOSCINE
BUTYLBROMID
E
1/2amp IV BD ✔ ✔ ✔ ✔ RELIVES STOMACH
PAIN
18. A S S E S S M E N T
01 02
03 04
PROBLEM:ABDOMINAL PAIN
MEDICATION: INJ BUSCOPAN
PROBLEM:FEVER
MEDICATION:INJ PCM
PROBLEM:INFECTION
MEDICATION:INJ MONOCEF
PROBLEM:VOMITING
MEDICATION:INJ ZOFER
19. PLAN
1 . T A B P A N 1 - 1 - 1
2 . T A B C A L P O L S O S
3 . T A B M O N O C E F
4 . T A B Z E R O D O L
20. R E G A R D I N G D I S E A S E
Cholelithiasis or gallstones are hardened
deposits of digestive fluid that can form in your
gallbladder. The gallbladder is a small organ
located just beneath the liver. The gallbladder
holds a digestive fluid known as bile that is
released into your small intestine
These gallstones may go on further to develop
complications such as cholecystitis, cholangitis,
choledocholithiasis, gallstone pancreatitis, and
rarely cholangiocarcinoma.
REGARDING MEDICATION
• while takeing inj.metrogyl alcohol
should be avoided
• pantaprezol should be taken 30
mins before meal
22. CLINCAL PEARL
• Cholelithiasis is the formation of hardest deposit in the fluid within the
gall bladder.
• Decreasing the cholesterol content in the bile can easily dissolve the
gall stones.
• A high fiber , low fat diet helps to keep bile cholesterol level in normal
form.
• Rapid loss of weight can develop gall stones.
Therefore get counseling from dietician and improve normal weight.
