Cholecystitis

1. Cholecystitis
Topic AHN-1
Prepared by :
Uzma Boota

2. Objectives
• At the end of this presantation; student will be able to
• Define cholecystitis
• Identity types of cholecystitis
• Described the pathophysiology of cholecystitis
• Enlist sign and symptoms and causes of cholecystits
• Enumerate the complications
• Enlist risk factor of cholecystitis
• Discuss medical diagnosis and treatment
• Make nursing diagnosis and nursing intervention

3. Cholecystitis
• " cholecystitis is inflammation of the gallbladder
which can be acute or chronic."

4. Types of cholecystitis
• It has two types:
• Acute cholecystitis
• Chronic cholecystits

6. Calculous cholecystitis
• A gallbladder stone obstructs bile outflow
• Bile remaining in the gallbladder initiates a
chemical reaction
• Autolysis and edema occure
• Blood vessels in the gallbladder are compressed
• Compromising its vascular supply

7. Acalculous cholecystitis
• Acute gallbladder inflammation in the absence of
obstruction by gallstones
• After major surgical procedure sever trauma or
burns
• Other factors torsion, cystic duct obstruction,
primary bacterial infection of gallstones and
multiple blood transfusions.

9. Sign and symptoms
• Sever pain and tenderness in upper right abdomen
• Pain could radiates from to right shoulder or back
• Nausea
• Vomiting
• Fever

10. Conti.....
• Feeling of fullness
• Jaundice
• Abdominal distension
• Fat intolerance
• Anorexia
• Leukocytosis

12. Causes of cholecystitis
• Cholecystitis is mainly caused by cholelithiasis (the
presence of choleliths or gallstones in the
gallbladder) and following:
• Female gender
• Certain ethnic group
• Obesity or rapid weight loss
• Drugs ( hormonal therapy in the woman)
• Pregnancy
• Increase age

14. Risk factors
• Advancing age
• Pragnancy
• Obesity
• Rapid waight loss
• Pre-existing diseass( diabetes , down syndrome)
• Reduce gallbladder empty

15. Conti......
• Hyperlipedemia syndrome
• Inborn disorder of bile acid metabolism
• Gallbladder stasis
• Oral contraceptives
• Female sex hormones
• Geneting predisposition

16. Diagnostic criteria
• Ultrasonography
• On examination
• Endoscopic retrograde cholangiopancreatography
(ERCP)
• Per cutaneous transhepatic cholangiography (PTC)
• Intraoperative cholangiography (IOC) at the time
ofcholycystectomy.

17. Treatment
• Surgical treatment
• Medical treatment
• Nursing intervention
• Nutritional managment
• Patient teaching

20. Medical treatment
• Pain medicine, antiemetics etc
• Remove the cause by pharmacotherapy, endoscopy
procedure
• Antibiotics to fight infection
• UDCA ( ursodeoxycholic acid ) to dissolve
cholesterol gallstones

21. Nursing treatment
• Improving breathing pattern and sami- Fowler's
position
• Improving skin tagrity
• Monitoring and managing potential complications
• Fluid and electrolytes disturbances and
hypoglycemia, weight daily, input and output
• Monitor sign of hemorrhage
• Monitor for cardiovascular neurological renal and
respiratory dysfunction

22. Patient teaching
• Patient educate to reduce anxiety and depression
• Preoperative and postoperative care.
• Pain managment
• Fluid and electrolytes balance
• Nutritional status: avoide fatty food and fluid
• Encourage fluid intake: modified diet provision,
balance, bowel routine

24. Nursing diagnosis
• Acute pain relative to gallbladder stones
• The risk of dehydration related to vomiting
• Ineffective breathing pattern relative to pain
secondary disease
• Ricks for infection relative to complication disease
• Imbalance nutrition less then body requirements
relative to alter lipids Metabolism.