| What is Gall bladder? | | | | * Ultrasound (Also called sonography.) - A diagnostic |
| The gallbladder is a pear-shaped organ that lies | | | | imaging technique which uses high-frequency sound |
| beneath the liver in the right-upper abdomen. The | | | | waves to create an image of the internal organs. |
| gallbladder is connected to the liver (which produces | | | | Ultrasounds are used to view internal organs of the |
| the bile) by the hepatic duct. Its function is to store bile. | | | | abdomen such as the liver spleen, and kidneys and to |
| When food containing fat reaches the small intestine, a | | | | assess blood flow through various vessels. Ultrasound |
| hormone called cholecystokinin is produced by cells in | | | | scans can also show thickening of the gallbladder wall, |
| the intestinal wall and is carried to the gall bladder via | | | | which is typical of chronic cholecystitis. |
| the bloodstream. The hormone causes the gall bladder | | | | * Hepatobiliary scintigraphy - Cholescintigraphy is an |
| to contract, forcing bile into the common bile duct. A | | | | imaging technique that is useful when acute |
| valve, which opens only when food is present in the | | | | cholecystitis is difficult to diagnose. In this test, a |
| intestine, allows bile to flow from the common bile duct | | | | radioactive tracer is injected intravenously and its |
| into the duodenum (upper intestine) where it functions | | | | movement from the liver through the biliary tract is |
| in the process of fat digestion. | | | | followed. Images are taken of the liver, bile ducts, |
| What is cholecystitis? | | | | gallbladder, and upper part of the small intestine. If the |
| Cholecystitis is an inflammation of the gallbladder wall | | | | tracer does not fill the gallbladder, it is presumed that |
| and nearby abdominal lining. Cholecystitis can occur | | | | the cystic duct is obstructed by a gallstone. |
| suddenly or gradually over many years. Acute | | | | * Cholangiography - x-ray examination of the bile ducts |
| cholecystitis is the sudden onset of inflammation of the | | | | using an intravenous (IV) dye (contrast). |
| gallbladder, resulting in severe, steady upper abdominal | | | | * Endoscopic retrograde cholangiopancreatography |
| pain (biliary colic), which may occur repeatedly. Chronic | | | | (ERCP) - a procedure that allows the physician to |
| cholecystitis is long-standing inflammation of the | | | | diagnose and treat problems in the liver, gallbladder, bile |
| gallbladder characterized by repeated attacks of pain | | | | ducts, and pancreas. The procedure combines x-ray |
| (gallbladder attacks) over a prolonged period. | | | | and the use of an endoscope - a long, flexible, lighted |
| At least 95% of people with acute cholecystitis have | | | | tube. The scope is guided through the patient's mouth |
| gallstones. Gallstones are stones which are formed in | | | | and throat, then through the oesophagus, stomach, and |
| the gallbladder. The Gall Bladder stores and | | | | duodenum. The physician can examine the inside of |
| concentrates bile. Sometimes the substances | | | | these organs and detect any abnormalities. A tube is |
| contained in bile crystallize in the gall bladder, forming | | | | then passed through the scope, and a dye is injected |
| stones. These small, hard concretions are more | | | | which will allow the internal organs to appear on an |
| common in persons over 40, especially in women and | | | | x-ray. |
| the obese. Rarely, acute cholecystitis occurs in a | | | | * Computed tomography scan (CT or CAT scan) - a |
| person without gallstones (acalculous cholecystitis). In | | | | diagnostic imaging procedure using a combination of |
| these cases the cause can be any major injury, | | | | x-rays and computer technology to produce |
| operation or burn, bacterial infection in the bile duct | | | | cross-sectional images (often called slices), both |
| system, tumor of the pancreas or liver. | | | | horizontally and vertically, of the body. A CT scan |
| What are the symptoms of cholecystitis? | | | | shows detailed images of any part of the body, |
| A gallbladder attack, whether in acute or chronic | | | | including the bones, muscles, fat, and organs. CT scans |
| cholecystitis, begins as severe, steady abdominal pain | | | | are more detailed than general x-rays. |
| (biliary colic). The person typically feels a sharp pain | | | | How is cholecystitis treated? |
| when a doctor presses on the upper right part of the | | | | The approach taken to treat cholecystitis depends |
| abdomen. The pain may worsen when the person | | | | upon: |
| breathes deeply and often extends to the lower part | | | | * Extent of the disease |
| of the right shoulder blade. The pain may become | | | | * Age, overall health, and medical history of the patient |
| excruciating; and may be accompanied by nausea and | | | | * Tolerance of specific medicines, procedures, or |
| vomiting. The pain usually lasts more than 12 hours. | | | | therapies |
| Within a few hours, the abdominal muscles on the right | | | | * Expectations for the course of the disease |
| side become rigid. Fever occurs in about one third of | | | | * Patient's opinion or preference |
| people but is less likely in older people. The fever tends | | | | For acute cholecystitis, initial treatment includes bowel |
| to be mild at first, and then rises gradually to above | | | | rest, intravenous hydration, intravenous antibiotics and |
| 100° F (38° C). Typically, an attack of cholecystitis | | | | pain management. Whether it is acute or chronic |
| subsides in 2 to 3 days and completely disappears in a | | | | cholecystitis, the physician then takes a step to identify |
| week. If the attack persists, it may signal a serious | | | | the cause. If the cause is gallstones, then he may |
| complication. This disorder initially produces symptoms | | | | suggest the conventional solution in which the gall |
| similar to those of indigestion, especially after a fatty | | | | bladder itself is removed. And if the physician feels that |
| meal is consumed. This may be accompanied by | | | | it is best to remove the gall bladder, he may advice the |
| nausea and vomiting. But when a stone becomes | | | | patient to undergo Cholecystectomy after the acute |
| lodged in the bile duct, it produces severe pain. Many | | | | phase subsides. Cholecystectomy merely means |
| people also remain asymptomatic. The symptoms of | | | | removal of the gallbladder. In acalculous cholecystitis, |
| cholecystitis may resemble gastric pain but one must | | | | immediate surgery is necessary to remove the |
| always consult their physician for a proper diagnosis. | | | | diseased gallbladder. Cholecystectomy again can be |
| How is it diagnosed? | | | | done by conventional method (also called open |
| Doctors diagnose cholecystitis, both acute and chronic, | | | | method) or by the laparoscopic method. We wish to |
| based on the person's symptoms and the results of | | | | provide our patients with complete information about |
| tests that suggest gallbladder inflammation. The | | | | the available treatments. So we are discussing (below) |
| physician will perform a careful abdominal examination | | | | both the conventional and new methods. |
| to confirm the diagnosis. The enlarged, tender | | | | The conventional method |
| gallbladder may be felt by the physician through the | | | | The conventional method, also called open method |
| abdominal wall. Pressure in the upper right corner of | | | | was initially the only standard treatment. This was the |
| the abdomen may cause the patient to stop breathing | | | | common treatment offered both for gallstone removal |
| in, due to an increase in pain. This is called Murphy's | | | | or gallbladder removal. This procedure required a 3 to |
| sign. Besides this, few diagnostic procedures may be | | | | 7 day stay in the hospital and a 3 to 7 inch incision and |
| advised. They include: | | | | scar on the abdomen. The surgeon makes an |
| * Blood tests: Increased levels of white blood cells | | | | abdominal incision under the right side of the rib cage, |
| suggest inflammation or infection or both. There may | | | | which cuts through the skin and muscle. The |
| also be increase in bilirubin levels. | | | | gallbladder is then located and removed. |