AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesHealth CareGeographicals
IleusCholecystitisGallstonesCholecystitis, AcuteGallbladderIntestinal ObstructionCholelithiasisAcalculous CholecystitisCholecystectomyGallbladder EmptyingIntestinal FistulaBiliary FistulaJejunal DiseasesIleal DiseasesGallbladder DiseasesSigmoid DiseasesGallbladder NeoplasmsCholecystographyUrinary BladderGastroscopesEmphysematous CholecystitisCholecystectomy, LaparoscopicImino AcidsCholecystostomyBileUrinary Bladder NeoplasmsCholecystolithiasisAirway ObstructionTechnetium Tc 99m DisofeninTomography, X-Ray ComputedTokyoCystic DuctTechnetium Tc 99m LidofeninUreteral ObstructionXanthomatosisIntestinal Pseudo-ObstructionLaparoscopyUrinary Bladder Neck ObstructionGangreneCholangitisRetrospective StudiesBiliary Tract DiseasesCommon Bile DuctCholecystokininAcute DiseaseBiliary TractCholangiographyPlant TumorsUrinary Bladder DiseasesGastric Outlet ObstructionUrsodeoxycholic AcidCholangiopancreatography, Endoscopic RetrogradeDuodenal ObstructionPostoperative ComplicationsMeconiumBile Acids and SaltsBile DuctsSphincter of OddiCholangiopancreatography, Magnetic ResonanceUrethral ObstructionCholesterolPancreatitisChoristomaCholestasisDrainageChenodeoxycholic AcidMucous MembraneTreatment OutcomeCholedocholithiasisBilirubinGastrointestinal MotilityUrinary Bladder, OveractiveBiliary Tract NeoplasmsDuodenal DiseasesRupture, SpontaneousNasal ObstructionTime FactorsHemobiliaTechnetium Tc 99m Diethyl-iminodiacetic AcidLithotripsyBile PigmentsSphincterotomy, EndoscopicPolypsUrinary Bladder, NeurogenicVentricular Outflow ObstructionBiliary DyskinesiaColicMotilinRadiography, AbdominalLaparotomyConversion to Open SurgeryUltrasonographyUrinary Bladder Calculi
CholelithiasisCholecystectomyAcalculous CholecystitisCystic ductComplicationsBile ductCholedocholithiasisAcuteCholangitisObstructive jaundiceInflammationRight upper quBiliary treeCholesterolStasisLiverUltrasoundPancreatitisStonesOccurCommonlyMechanicalInfectionNauseaSurgeryLaparoscopyAdultsPatient'sBilirubinLaparoscopicPresenceBacterialSymptomsDiabetesConstipationAbdominal aortic aCommonOccursRiskPresentAsymptomaticConditionExaminationIncludeOutpatientManagementFoundSignsDiagnosisDevelop
Cholelithiasis5
Cholecystectomy4
  • Furthermore, biliary pain may be associated with functional disorders of the biliary tract, so-called acalculous biliary pain (pain without stones), and can even be found in patients post-cholecystectomy (removal of the gallbladder), possibly as a consequence of dysfunction of the biliary tree and the sphincter of Oddi. (wikipedia.org)
  • Complications from gallstone disease is 0.3% per year and therefore prophylactic cholecystectomy are rarely indicated unless part of a special population that includes porcelain gallbladder, individuals eligible for organ transplant, diabetics and those with sickle cell anemia. (wikipedia.org)
  • Cholecystectomy of the Pregnant Patient. (booksca.ca)
  • A laparoscopic cholecystectomy (LC) is the treatment of choice for gallbladder diseases. (hvt-journal.com)
Acalculous Cholecystitis1
Cystic duct5
Complications6
Bile duct3
  • Alanine aminotransferase and aspartate transaminase are usually suggestive of liver disease whereas elevation of bilirubin and alkaline phosphatase suggests common bile duct obstruction. (wikipedia.org)
  • If the stones become large enough, they may even lodge into the bile duct and cause a physical obstruction that would be extremely painful and possibly life threatening. (drjockers.com)
  • If gallstones block the bile duct, the risk of infection go up. (drjockers.com)
Choledocholithiasis2
Acute9
Cholangitis2
Obstructive jaundice1
  • 50 μmol/L). The patient may also complain of pruritus (itching), as a result of bile accumulation, and pale stool with dark urine, from the obstructive jaundice. (teachmesurgery.com)
Inflammation4
  • About 15% of people with biliary colic eventually develop inflammation of the gallbladder if not treated. (wikipedia.org)
  • [13] Because of the inflammation, its size can be felt from the outside of the body in 25-50% of people with cholecystitis. (wikizero.com)
  • Mechanical irritation by gallstones can also produce chronic GB inflammation. (lecturio.com)
  • Cholecystitis is the inflammation Inflammation Inflammation is a complex set of responses to infection and injury involving leukocytes as the principal cellular mediators in the body's defense against pathogenic organisms. (lecturio.com)
Right upper qu3
  • The gold standard imaging modality for the presence of gallstones is ultrasound of the right upper quadrant. (wikipedia.org)
  • Patients are commonly asymptomatic but may present with biliary colic (intermittent pain in the right upper quadrant). (lecturio.com)
  • Patient status post gastric bypass surgery, developed nausea and right upper quadrant pain. (mtsamples.com)
Biliary tree1
  • During an obstruction, stasis of fluid combined with elevated intraluminal pressure allows the bacterial colonisation of the biliary tree to become pathological. (teachmesurgery.com)
Cholesterol6
Stasis3
  • Biliary stasis is a key component in gallstone formation. (amboss.com)
  • Increased progesterone levels cause smooth muscle relaxation, decreased gallbladder contraction, and subsequent bile stasis with formation of gallstones . (amboss.com)
  • This is a condition known as stasis where bile sits in the gallbladder for long periods of time and moves slowly when it finally gets going. (drjockers.com)
Liver8
  • Peritonitis is most often caused by introduction of an infection into the otherwise sterile peritoneal environment through organ perforation, but it may also result from other irritants, such as foreign bodies, bile from a perforated gall bladder or a lacerated liver, or gastric acid from a perforated ulcer. (medscape.com)
  • [1] Risk factors for gallstones include birth control pills , pregnancy , a family history of gallstones, obesity , diabetes , liver disease , or rapid weight loss . (wikizero.com)
  • Gallstones are a sign of incomplete liver detoxification and pose a significant threat to the body ( 1 ). (drjockers.com)
  • The gallbladder serves as a reservoir for the bile that is produced by the liver. (drjockers.com)
  • The gallbladder is an organ located underneath the liver in the upper right part of the belly just below the ribcage. (apsapedsurg.org)
  • The liver makes bile and gallbladder normally stores bile. (apsapedsurg.org)
  • Specialty that treats diseases and pathology of the gastrointestinal tract, such as the esophagus, stomach and intestinal tract as well as diseases of the liver, gallbladder and pancreas. (mtsamples.com)
  • The patient is noted to have an increase in her liver function tests on routine blood work. (mtsamples.com)
Ultrasound2
Pancreatitis2
Stones1
  • Gallstone formation occurs from the precipitation of crystals that aggregate to form stones. (wikipedia.org)
Occur2
Commonly2
Mechanical1
  • Rarely, a gallstone can become impacted in the ileocecal valve that joins the caecum and the ileum, causing gallstone ileus (mechanical ileus). (wikipedia.org)
Infection1
  • It is caused by a combination of biliary outflow obstruction * and biliary infection . (teachmesurgery.com)
Nausea1
Surgery4
  • Studies published in the 1980s and 1990s demonstrated that, among elderly patients presenting to the ED with abdominal pain, at least 50% were hospitalized and 30-40% eventually had surgery for the underlying condition. (medscape.com)
  • Treatment for gallbladder attacks is typically surgery to remove the gallbladder. (wikipedia.org)
  • [4] In people unable to have surgery, gallbladder drainage may be tried. (wikizero.com)
  • A review study in the British Medical Journal found that 50% of patients who had a gallbladder surgery didn't see improvement in their digestive health complaints ( 5 ). (drjockers.com)
Laparoscopy1
Adults4
  • For patient education resources, see Digestive Disorders Center , as well as Abdominal Pain (Adults) , Appendicitis , Diverticulitis (Diverticulosis) , Gastroenteritis (Stomach Flu) , Constipation (Adults) , and Blood in the Urine . (medscape.com)
  • In the developed world, 10 to 15% of adults have gallstones. (wikipedia.org)
  • About 10-15% of adults in the developed world have gallstones. (wikizero.com)
  • About 10-20% of American adults have gallstones . (amboss.com)
Patient's2
Bilirubin1
  • Routine bloods should be taken, especially FBC ( leucocytosis is found in the vast majority of patients) and LFTs (showing a raised ALP ± GGT with a raised bilirubin ). (teachmesurgery.com)
Laparoscopic1
Presence1
  • However, the presence of gallstones is a frequent incidental finding and does not always necessitate treatment, in the absence of identifiable disease. (wikipedia.org)
Bacterial1
  • in addition, paracentesis should be performed in all patients who do not have an indwelling peritoneal catheter and are suspected of having SBP, because results of aerobic and anaerobic bacterial cultures, used in conjunction with the cell count, are useful in guiding therapy. (medscape.com)
Symptoms4
  • Elderly patients tend to wait much longer to seek medical attention than younger patients, and they are much more likely to present with vague symptoms and have nonspecific findings on examination. (medscape.com)
  • [9] Cholecystitis is suspected based on symptoms and laboratory testing. (wikizero.com)
  • Most people with gallstones do not have symptoms. (wikizero.com)
  • His magnum opus, De Sedibus et Causis Morborum per Anatomem Indagatis , published in 1761, describes the findings of over 600 partial and complete autopsies, organised anatomically and methodically correlated with the symptoms exhibited by the patients prior to their demise. (bionity.com)
Diabetes2
  • Many elderly patients have underlying conditions such as diabetes or malignancy, further suppressing immunity. (medscape.com)
  • Hematemesis in a patient with longstanding diabetes. (mtsamples.com)
Constipation1
  • Because of these factors, many elderly patients with serious pathology initially are misdiagnosed with benign conditions such as gastroenteritis or constipation. (medscape.com)
Abdominal aortic a2
  • Elderly patients often have underlying cardiovascular and pulmonary disease, which decreases physiologic reserve and predisposes them to conditions such as abdominal aortic aneurysm (AAA) and mesenteric ischemia . (medscape.com)
  • When a young patient presents with abdominal aortic aneurysm, there may be an underlying cause. (biomedcentral.com)
Common2
Occurs1
Risk3
  • This triad is not only a risk for heart disease, but also gallstones ( 6 ). (drjockers.com)
  • Women who have used birth control pills, hormone replacement therapy (HRT) or have an IUD are at a higher risk for gallstone formation ( 7 ). (drjockers.com)
  • Medication including oral contraceptive pill and fibrates can increase the risk, and a lipid-rich diet may be indicative of gallstones (as a potential underlying cause). (teachmesurgery.com)
Present2
  • Understanding that elderly patients may present very differently than their younger counterparts also is important. (medscape.com)
  • Cholecystitis will present with RUQ pain and fever yet jaundice will be absent. (teachmesurgery.com)
Asymptomatic1
  • Elderly patients also have a high incidence of asymptomatic underlying pathology. (medscape.com)
Condition1
  • Another condition, called gallbladder ileus happens when a gallstone slips into the small intestine and blocks the entry of bile to the small intestine. (drjockers.com)
Examination2
  • On physical examination, an inflamed gallbladder is almost always tender to the touch and palpable (~25-50% of cases) in the midclavicular right lower rib margin. (wikizero.com)
  • On questioning, these patients denied any intake of food for at least 8 hours prior to the examination, but it was revealed that a large proportion of these patients had been preparing food for the family prior to their visit to the hospital. (docksci.com)
Include2
  • The primary functions of the gallbladder include concentrating and storing up to 50 mL of bile. (lecturio.com)
  • Therefore, in conclusion, it is probably not unreasonable to include the advice of refraining from the cooking of food for optimal gallbladder distension prior to cholecystosonography. (docksci.com)
Outpatient2
  • B Banerjee and I Brett Department of Radiodiagnosis and Imaging, Tameside General Hospital, Fountain Street, Ashton-under-Lyne, Lancashire Over a period of several years it has been noticed that in a number of patients undergoing cholecystosonography, as in outpatient procedures, the gallbladder was found to be contracted although otherwise appeared normal. (docksci.com)
  • The patient was referred for an outpatient speech and language pathology consult to increase speech and swallowing abilities. (mtsamples.com)
Management5
Found1
Signs1
  • Patients usually have normal vital signs with biliary colic, whereas patients with cholecystitis are usually febrile and more ill appearing. (wikipedia.org)
Diagnosis2
  • In fact, two newer studies showed that CT scanning significantly improved the certainty of diagnosis and altered therapy in elderly patients. (medscape.com)
  • The patient is a very pleasant 72-year-old female with previous history of hypertension and also recent diagnosis of C. diff, presents to the hospital with abdominal pain, cramping, and persistent diarrhea. (mtsamples.com)
Develop2