A small research presentation about cholecystitis

2.  At the end this presentation everyone will be able understand:
 What is cholecystitis
 An idea about acute and chronic cholecystitis.
 Cause of cholecystitis
 Signs and symptoms of cholecystitis
 Medical management
 Surgical management
 Nursing management
 The effects and disorders in elderly

3.  Introduction
 Acute Cholecystitis
 Chronic Cholecystitis
 Cause
 Sign and Symptoms
 Medical Management
 Surgical Management
 Nursing Management
 Effect and Disorders in elderly

4. Cholecystitis is inflammation of the gallbladder. Your
gallbladder is a small, pear-shaped organ on the right
side of your abdomen, beneath your liver. The
gallbladder holds a digestive fluid that's released into
your small intestine
 Acalculous cholecystitis is an inflammatory disease of the gallbladder without
evidence of gallstones or cystic duct obstruction.
 Calculous cholecystitis develops when the main opening to the gallbladder, called the
cystic duct, gets blocked by a gallstone or a substance known as biliary sludge

5.  Acute cholecystitis occurs when bile becomes trapped in the gallbladder.
 This often happens because a gallstone blocks the cystic duct, the tube through which
bile travels into and out of the gallbladder.
 When a stone blocks this duct, bile builds up, causing irritation and pressure in the
gallbladder.
 This can lead to swelling and infection.

7.  The onset is usually insidious, sometimes following repeated acute attacks.
 Gallstones are invariably present and there may be accompanying biliary colic.
 Secondly infection with suppuration may develop.
 Without treatment, ulceration of the of the tissues between the gallbladder and
the duodenum or colon may occur with the fistula formation and, later, fibrous
adhesion.
 this condition is associated with cancer of gallbladder.

8. Cholecystitis occurs when your gallbladder becomes inflamed. Gallbladder
inflammation can be caused by:
 Gallstones. Most often, cholecystitis is the result of hard particles that develop in
your gallbladder (gallstones). Gallstones can block the tube (cystic duct) through
which bile flows when it leaves the gallbladder. Bile builds up, causing
inflammation.
 Tumor. A tumor may prevent bile from draining out of your gallbladder properly,
causing bile buildup that can lead to cholecystitis.
 Bile duct blockage. Kinking or scarring of the bile ducts can cause blockages that
lead to cholecystitis.
 Infection. AIDS and certain viral infections can trigger gallbladder inflammation.
 Blood vessel problems. A very severe illness can damage blood vessels and decrease
blood flow to the gallbladder, leading to cholecystitis.

10.  Signs and symptoms of cholecystitis may include:
 Severe pain in your upper right or center abdomen
 Pain that spreads to your right shoulder or back
 Tenderness over your abdomen when it's touched
 Nausea
 Vomiting
 Fever

11.  Fasting. The patient may not be allowed to drink or eat at first in order to take
stress of the inflamed gallbladder; IV fluids are prescribed to provide temporary
food for the cells.
 Supportive medical care. This includes restoration of hemodynamic stability and
antibiotic coverage for gram-negative flora.
 Gallbladder stimulation. Daily stimulation of gallbladder contraction with IV
cholecystokinin may help prevent the formation of gallbladder sludge in the
patient receiving TPN.

12.  Cholecystectomy. Cholecystectomy is most performed by using a laparoscope and
removing the gallbladder.
 Endoscopic retrograde cholangiopancreatography (ERCP). ERCP visualizes the
biliary tree by cannulation of the common bile duct through the duodenum.

13.  Pain assessment. Observe and document location, severity (0-10 scale),and
character of pain.
 Activity. Promote bedrest, allowing the patient to assume a position of comfort.
 Communication. Make time to listen and to maintain frequent contact with the
patient.
 Calories. Calculate caloric intake to identify nutritional deficiency or needs.
 Food planning. Consult the patient about likes and dislikes, foods that causes
distress, and preferred meal schedules.
 Promote appetite. Proved a pleasant atmosphere at mealtime and remove
noxious stimuli.
 Laboratory studies. Monitor laboratory studies; BUN, pre-albumin, total protein,
transferrin levels.

14. The elderly people are more likely to have cholecystitis.
 This maybe due to their high cholesterol level
 There gallbladder may not work properly due to old age.
 Some time surgeons may not be able to perform surgery due the
condition of the patient and leads to death of the patient. elderly
patients may not be able to tolerate the surgery

16.  http://uoflphysiciansse3.adam.com/content.aspx?productId=117&pid=1&gid=0002
64
 Ross and Wilsons anatomy and physiology in health and illness, 12th edition.