Calculous cholecystitis is called acute or chronic inflammation in the gallbladder, when wherein in the lumen or duct bubble detected concrements (stones) of different sizes and amount.
The disease can last for years, and periodically sharpening unabated but steadily progressing. Calculous cholecystitis suffers about 10% of the adult population, and women are affected in several times more often than men. It is found in the age of 40-50 years, although there may be cases in children. The major danger is the displacement of concretions in the bladder neck area and the common bile duct - then formed jaundice and biliary colic episodes.
Types calculous cholecystitis
Allocate acute and chronic form, wherein for each of them may be smooth and complicated.
The acute form of calculous cholecystitis is rare, it usually manifests itself as a result of prolonged asymptomatic cholelithiasisIn which due to occlusion of the common bile duct stone inflamed bladder wall. This happens when the penetration into the region of the bladder infection to surrounding organs due to violations of the antiseptic properties of bile. As a result, it developed rapidly thickening of the walls and their degradation (destruction), which may lead to accumulation of pus inside the bladder and gall formation
peritonitis.In chronic calculous cholecystitis inflammation develops slowly and manifests itself in periods of exacerbation, the infectious factor is not so significant role. In the development of calculous cholecystitis are the leading disorders in the composition of bile, its thickening and congestion, irritation of the bladder wall. This usually occurs due to errors in the diet, obesity, Diabetes, endocrine shifts and frequent infections. Contributing factors are biliary dyskinesia, Liver disease, chronic gastritis and duodenitis.
Symptoms of acute and chronic forms
Manifestations cholecystitis depend on the type of disease.
In acute calculous cholecystitis there is an attack of biliary colic:
- this sharp pain in the right side, extending to the right shoulder or arm, usually provoked by nutritional errors, stress or alcohol intake,
- having nausea with vomiting, not bringing relief can be an admixture of bile in the vomit.
- body temperature rises, especially at a purulent inflammation,
- dramatically reduced blood pressure,
- there is a cold sweat and weakness,
- can be symptoms jaundice, Changes in urine and feces.
In chronic calculous cholecystitis symptoms are not as sharp, and somewhat different. Typical are:
- constant nagging and dull pain in the right hypochondrium,
- pain attacks after a fatty meal, fried or salt occurring in 2-3 hours,
- the occurrence of episodes of acute pain with errors in diet, which gradually subside
- may be nausea, belching bitter,
- in violation of the diet may experience vomiting bile,
- fever does not occur no pressure fluctuations.
Overall condition is not violated in the interictal period.
Diagnostics
When suspected acute cholecystitis necessary call ambulance and admission to hospital, as is sometimes required emergency surgery. Such forms cholecystitis surgeons treat basically.
In chronic cholecystitis diagnosis and treatment conducted by a doctor, gastroenterology outpatient or in the hospital (typically in the acute stage).
typical of the above complaints, combined with the study of common blood and urine levels of pancreatic enzymes and liver function tests, evaluations are necessary for diagnosis analysis of feces (Coprogram). Be sure to hold Ultrasound examination of the gallbladderAnd holetsistografii (obtaining X-ray images with the contrast introduction accumulated in bile). A useful study would duodenal intubation to produce bile portions and study its properties, giving an idea of the nature of the stones.
Treatment of calculous cholecystitis
Apply conservative and surgical methods.
In the acute form
In acute calculous cholecystitis, has arisen for the first time, begin with antibacterial, antispasmodic, analgesic therapy administered detoxification solutions using methods dietary correction and preventive treatment. Treatment is carried out permanently. Self-medication is prohibited.
With the ineffectiveness of these measures or the dangers of complications - the formation of abscesses with pus, showing removal of the gallbladder with stones. Today, this operation is carried out on the possibility of minimally invasive techniques - laparoscopically, through punctures in the abdomen manipulators under the supervision of a monitor. When such an operation impossible (complications, peritonitis) open laparotomy is performed to remove the bladder and abdominal revision.
In the chronic form
The mainstay of treatment of chronic calculous cholecystitis - it's strict adherence diet in pristupnaya and attack-free period, with the exception of food vysokouglevodistoy and fatty foods, minimizing salt and spices, complete abstinence from alcohol.
You must decrease physical exertion and emotional stress, weight correction.
After calming down aggravation appointed litholytic therapy - the use of drugs that dissolve gallstones - ursosan, Henofalk, litofalka. Used antispasmodic drugs.
Traditional medicine in the treatment of cholecystitis
You need to know that the use of traditional medicine in the form of decoctions or infusions of herbs have choleretic properties dangerous. These drugs can activate the movement of stones and cause aggravation, blockage of the bile duct and colic.
In recent years, calculous cholecystitis is widely used method for non-invasive lithotripsy - crushing gallstones influence of shock wave therapy or special ultrasound.
However, it is believed that conservative therapy only brings temporary relief in the treatment of cholecystitis, it eliminates the symptoms of inflammation and is temporary in nature. Following lithotripsy stone formation may again be repeated, if not normalize metabolism and not be on a constant diet.
More on the topic:
- chronic cholecystitis
- acalculous cholecystitis
