Gallbladder Attacks Essay

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

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.

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

Gallstones are described as digestive fluid that has hardened which can be very painful. They form in the gallbladder which is a pear shaped organ that is located on the right side of of the abdomen right underneath the liver. Gallstones can be many sizes which varies how much the pain is. They can be as small as a crumb to a size of a golf ball! Ouch! Also, some people have more than one, while other people may just have one. More than likely, you will have symptoms if you have gallstones and if you do have symptoms, most people have to get gallstone removal surgery. These symptoms may include, sudden pain in your upper right side of the abdomen or under the breast, back pain between shoulder blades, right shoulder pain, nausea, or vomiting.

The initial plan started with ordering a CBC, CMP, amylase and lipase STAT. These are all standard labs that help to rule out gallbladder pathology as well as our other differential diagnoses. Her vital signs were stable and the physical exam revealed only moderate TTP of the RUQ and epigastric region. The lab results revealed no leukocytosis, no elevation of liver enzymes, bilirubin, amylase, lipase, alk phos or any other signs of cholecystitis, cholangitis, pancreatitis or other potential signs of infection. The plan of care began with keeping the patient NPO. This is recommended as this keeps the patient from further pain secondary to food stimulating gallbladder contraction.5 It also allows the patient to be prepared for surgery if urgent cholecystectomy is required. The next step was beginning IV normal saline to keep her well hydrated. After this we began to give her medication through the IV including Zofran for her nausea. Zofran is an effective anti-emetic and there were no contraindications for use in this patient. We also gave her Morphine 2 mg IV for pain control. Opioids are an effective option for a patient with significant biliary colic.6 Although NSAIDS are another option for pain control, PUD was part of the differential diagnosis so NSAIDS were not an appropriate therapy. We ordered an abdominal ultrasound as this is the diagnostic test of choice for cholelithiasis. The ultrasound revealed multiple gallstones in the gallbladder, some mild gallbladder thickening, and some dilatation of the common bile duct. At this point we consulted GI who scheduled the patient for MRCP in the morning in order rule out choledocholithiaisis. We also consulted the surgery team who admitted the patient. The stated they would likely plan for laparoscopic

Crohn’s Disease was named after an American gastroenterologist, Dr. Burrill Bernard Crohn, in 1932. He and his colleagues discovered an abnormal pathogen, Mycobacterium paratuberculosis while studying a related disease, ulcerative colitis, which belongs to a larger group if illnesses called Inflammatory Bowel Disease (IBD). The discovery was made while studying the effects of ulcerative colitis in cattle and noticing the similar characteristics in humans. The infections had an abnormal response with the body’s immune system in both the cattle and humans.

The name for these erosions is aphthous ulcers. These erosions, after a while, start to deepen and grow in diameter. Once they reach a certain size, they can be referred to as ulcers. These ulcers can cause scarring and they can also cause the bowel to become stiff and lose its elasticity. As Crohn’s worsens, the bowel becomes obstructed once the passageways narrow enough. This obstruction can cause a buildup of food that is still being digested, fluid and gas that comes from the stomach. This obstruction will then prevent all of those products from entering into the colon. This will cause severe abdominal cramps, nausea, vomiting, and even abdominal distention. If the ulcers located in the walls of the bowel become large or extreme enough, holes can form in the walls of the bowel. Once those holes are formed in the bowel, the bacteria normal to the bowel can then pass through those holes and spread to nearby organs and into the abdominal cavity causing what are called fistulas. These fistulas are like a channel/tunnel that is formed between the ulcer and the adjacent organ. Then when a fistula is created between the affected intestine and the bladder, it is called an enteric-vesicular fistula which can lead to UTI’s and feces being presented during urination. Next, when the fistula is formed between the intestine and skin, it is called an enteric-cutaneous fistula. What this fistula, pus and mucous exit the body through a painful opening found in the skin of the

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).

Crohn et al. mention a sort of catch-all group of diseases that could potentially answer for these types of lesions, which they refer to as “benign granulomas” (1323). The term simply refers to most conditions which cause growth-like inflammations at various sites in the lower digestive tract (Crohn et al. 1324). Unsatisfied with lumping in their findings under this umbrella term as several before them had, they define it initially as the titular regional ileitis (Crohn et al. 1324).

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.

Cirrhosis is the twelfth major cause of death in the United States (McCance & Heuther, 2014). Cirrhosis is also the fifth major cause of mortality for patients between the ages of 45-54 (Talwalkar & Kamath, 2005). Cirrhosis affects women 50% less than men. Additionally, mortality due to cirrhosis is more common in African Americans than other ethnicities (Lewis, Dirksen & Heitkemper, 2014).

Cirrhosis has many causes, although the most common ones are alcoholism and chronic viral hepatitis B, and C. Cirrhosis can develop as a

The patient had a sudden onset of lower left quadrant pain and was diagnosed with

The removed gallbladder was placed in a 10% formalin solution, to uphold the integrity of the specimen. It was labeled with patient’s name, date of birth, medical record number, surgeon, healthcare facility, type of specimen and date and time of specimen collection. This data was verified by the same scrub and scout nurses, for consistency and in

Cholecystitis affects women more often than men and is more likely to occur after age 40. People who have a history of gallstones are at increased risk for cholecystitis. Cholecystitis has an increased prevalence among people of Scandinavian descent, Pima Indians, and Hispanic populations. It affected 20 million people with a mortality record of 1,092 deaths in 2004. Hospitalizations total up 622,000 in the same year and over 700,000 have undergone cholecystectomies.