Acute Cholecystitis In Emergency Department

Cholecystitis is inflammation of the gallbladder. Inflammation usually forms when a gallstone blocks the cystic duct that transports bile. Cholecystitis is the most common problem resulting from gallbladder stones (90% of the cases).

Acute Pancreatitis: Acute inflammation of the pancreas.The most common pathogenic mechanism is autodigestion of the pancreas. The etiological factor injures pancreatic cells or activates the pancreatic enzymes in the pancreas rather than in the intestine which may be due to reflux of bile acids into the pancreatic duct through an open or distended sphincter of Oddi. The result may also be caused by blockage created by a gallstone. Obstruction of pancreatic ducts results in pancreatic ischemia.The pathophysiology involvement of acute pancreatitis is

The liver produces bile which contains conjugated bilirubin. It is then sent to the gallbladder, and it has to be excreted properly from there. However, the gallstones are blocking the way, which makes it hard for the bilirubin to get out, and results in a build-up. This leads to jaundice, which occurs when one has and excessive amount of bilirubin.

During surgery, my gallbladder was found to have been very inflamed and infected, (but had no stones in it). Then my liver was found to have been very infected, the day after that. With a serious infection, there should have been fever present, but I had two of them and no fever. Yet, another strange fact about that illness.

Gallstone disease represents an important issue in the healthcare system and one of the most common and costly of all digestive diseases if we consider the number of cholecystectomies, which are performed annually all over the world, and the hospital admission rate for complicated gallstone disease (Guarino et.al., 2013). Gallstone disease is a disorder where genetics and the environment plays a major factor. Some of the risk factors that contribute to the disease are age, gender, race, parity, and dietary factors (Guarino et. al., 2013). Gallstones are hard deposits that can be extremely small or as large as tangerine, and they tend to roam around in your gallbladder. Gallstones develop where there is too much cholesterol in the bile. When

A 24 year old female at 27 weeks gestation presented to our institution with abdominal pain and concern for preterm labor. The patient had undergone a laparoscopic cholecystectomy for chronic cholecystitis ten days prior at another institution, which is where she presented for a prenatal visit. In the transfer record, patient had multiple recent admissions due to emesis, attributed to hyperemesis gravidum and cholecystitis. On admission to our institution, she complained of uncomfortable cramping abdominal pain with concern for preterm labor. She was febrile, with a leukocytosis of 26.3. The obstetric service performed a negative amniocentesis for what they suspected to be chorioamnionitis. Ten hours after admission, her pain failed to improve, she was placed on piperacillin/tazobactam. MRI was obtained and demonstrated a

Blood test to look for complications: the blood test may reveal jaundice, an infection, pancreatitis or other complications caused by Gallstone.

Another factor is rapid weight loss. As the body metabolizes fat during rapid weight loss, it causes the liver to secrete extra cholesterol into bile, which can cause gallstones.

The gallbladder holds approximately 90ml of concentrated bile. Each day 700 to 1200 ml of bile is secreted and drained into the common bile duct and into the duodenum. (Kathryn L. McCance, 2014) As outlined earlier the blockage of the Sphincter of Oddi will cause all of this bile to be forced back up the common bile duct and into the gallbladder. The amount of fluid produced in a day far outweighs the capacity of the gallbladder causing it to become distended. This distention activates the pain fibers causing abdominal discomfort, especially during large meals. The same mechanism is found when the pancreas secretes pancreatic enzymes. The enzymes become stuck at the SO and are required to travel back up the main pancreatic duct into the pancreas; this causes pain and discomfort due to the distention of the

Cholecystitis is an inflammation of the gallbladder. The gallbladder is a pear-shaped organ that lies beneath the liver on the right side of the body. The gallbladder stores bile, which is a fluid that helps the body digest fats. This condition may be sudden (acute) or occur over long periods of time (chronic). Cholecystitis is serious and needs treatment right away.

Gallstones are more common in women and are the predominant cause of pancreatitis. While the etiology for men is mostly dependent on chronic alcohol consumption which in return leads to chronic pancreatitis (Croghan, 2014. Pg. 1030). Pancreatitis occurs accompanied by the formation of biliary sludge. Croghan (2014) describes biliary sludge or microlithiasis as a mixture of cholesterol crystals and calcium salts. This occurs in conjunction with bile stasis. Biliary sludge is found in 20-40% of patients with acute pancreatitis (Croghan, 2014, pg. 1030). Other causes of the disease are attributed to, hypertriglyceridemia, trauma and viral infection, duodenal ulcer, Kaposi sarcoma, cystic fibrosis, metabolic disorders and vascular disease. However, hypertriglyceridemia is the most common cause. Hypertriglyceridemia occurs when serum levels exceed 1000 mg/dL (Croghan, 2014, pg. 1030). Developing pancreatitis often is dependent on a set of particular risk factors. These include smoking, drinking and a high fat

The gallbladder is known for being a storage space for bile in the form of a pear that is partially accommodated in a shallow depression on the inferior area of the

The incidence of postoperative bile leak cannot be assessed accurately as many cases may heal spontaneously. (14) Postoperative bile leak usually occurs from the liver bed or bile duct injury, (15) as a result of pressure gradient created by the sphincter of Oddi. (16) The commonest cause of postoperative bile leak was post-cholecystectomy and the commonest site was the cystic duct stump, and this was comparable with the previously published results. (17) Cholangiogram was the standard method of the diagnosis in most cases, however, the leak was minimal and not evident in 25 cases, such cases may heal spontaneously according to the literature.

The bile which is produced in the gall bladder can also be part of the problem as a human body needs bile, but if it contains too much of cholesterol in it, that it may result in the development of gallstones more likely.

The gallbladder stores and concentrates bile. If the gallbladder was damaged or dysfunctional there would be softer and more frequent stools. (Audesirk, T., & Audesirk, G. (1999). Retrieved November 21, 2015 from Chapter 29: Nutrition and Digestion. In Biology: Life on Earth (5th ed., p. 585, 586). Upper Saddle River, N.J.: Prentice Hall.) (General Surgery- Gallstones (Cholelithiasis). (n.d.). Retrieved November 21, 2015, from