Cholecystitis and Perioperative Care Essay

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).

When I became sick I later found out it was due to gallbladder issues. I was having severe chest pains and I couldn’t keep any food down, not even crackers. I was never aware of the cause of this till I was hospitalized with the worst chest pain. I had over eight hours of chest pains

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

I knew the severe symptoms that I had were not characteristic of gallbladder disease. Particularly not in the beginning, when there was only a very small amount of gallbladder sludge. The very elevated liver enzymes I had were also a mystery because they also do not occur when there is gallbladder sludge alone. They can occur when there is sludge blocking a duct, but there never appeared to be any obstructed ducts in either of the ultrasounds I had during that

Obstetric Cholestasis (OC) or Intraheptic Cholestasis of pregnancy is a disorder that is unique to pregnancy (Kelly and Nelson-Piercy, 2000).OC classically presents in the third trimester (Royal College of Obstetricians and Gynaecologists [RCOG], 2006), With maternal pruritus and raised bile acids (Geenes and Williamson, 2009).It is one of the few disorders of pregnancy that can affect both maternal well being and fetal outcome. OC usually resolves forty eight hours after delivery (Mays, 2010).

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.

Bile is a brownish bitter alkaline fluid produced by the liver and made by the hepatocytes from water, bile salts, bile pigments cholesterol and phospholipids and stored in the gall bladder. Bile is directly connected with digestion. It is released sporadically into the small intestine (duodenum) which is part of the gut in order to help digestion. Bile contains chemicals that break down/emulsify fats by dispersing fat globules into small droplets, therefore increasing the surface area, in turn speeding up the reaction. When fats get to the small intestine they

If after eating fatty foods, you experience belly pain and/or nausea , you might have gall stones. If you want to avoid having gall stones (because it can further lead to colon cancer) you need to go on a gall stone diet.

When a cystic duct is continuously obstructed inflammation occurs. Bile stasis triggers release of inflammatory enzymes and can be caused by fasting, obstruction, postsurgical/procedural irritation or ileus (total parenteral nutrition [TPN]), which can lead to bile inspissation that is directly toxic to the gallbladder epithelium. The damaged mucosa secretes more fluid into the gallbladder lumen than it absorbs. The resulting distention further releases inflammatory mediators (eg, prostaglandins), worsening mucosal damage and causing ischemia, all of which prolong inflammation and can cause a bacterial infection to occur later. The malicious circle of fluid secretion and inflammation leads to necrosis and perforation if it goes unchecked. If acute inflammation resolves then continues to recur, the gallbladder becomes fibrotic and contracted and does not concentrate bile or empty normally which is a feature of chronic cholecystitis. (Huffman, J. et al.,

Also, in some rare cases, surgery is required, life threatening bleeding, perforation of the intestine and inflammation of the abnormal cavity may occur. Other risk factors are inflammation of the joints, eyes, skin and/or liver, malnutrition and partial blocking of the bile ducts which carry bile from the liver to the intestine, however, there is much that can be done about all these complications. One risk and a major one is colon cancer. The risk of developing colon cancer increases when the disorder begins in the childhood, the disorder has been present for more then 8 years and when there is a history of colon cancer in the family. There have cases that colitis can become so severe that the removal of the colon had to be done. It affects everyone differently.

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.

Diagnostic testing: Physical examination by testing for the Murphy’s sign along with the presenting symptoms can help diagnose cholecystitis. Complete blood count showing leukocytosis with a left shift, elevated AST, ALT, bilirubin is usually seen in cholecystitis. Ultrasonography is the foremost imaging study for diagnosing cholecystitis. An alternative for ultrasonography is scintigraphy. Other imaging studies include CT scan with or without contrast and MRI.

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

The bile moves into the gallbladder via tiny tubes. The bile is stored in the gallbladder and waits, becoming concentrated, for the signal to be released into the duodenum aiding in digestion. Without bile, the body could not digest fats, as fats do not absorb into water. The bile acts as a detergent and allows the two to mix.

This substance is produced when a human digests lipids or fats. According to Sareen Gropper and Jack Smith’s “Advanced Nutrition and Human Metabolism” bile is produced through the process of chemically altering cholesterol, which is a type of fat found in a human’s blood. This process takes place in the liver and bile acids are produced. These bile acids are then conjugated or united with taurine and glycine to produce biosurfactants known as bile salts. The existence of bile salts inside of bile gives the substance the capacity to amalgamate lipids and fats with their aqueous (watery) environment inside of the gallbladder. According to Sareen Gropper and Jack Smith’s “Advanced Nutrition and Human Metabolism” bile is released from its origin (gallbladder) into the small intestine. Through the process of emulsification the bile substance in the small intestine disintegrates fats into much tinier particles which can be digested and absorbed at a much more efficient and quicker rate. This evidently shows that without bile and in turn bile salts the digestion of fats will not be