Acalculozica acute cholecystitis

Acalculozica acute cholecystitis

    * Introduction
    * Symptoms and Diagnosis
    * Treatment
Acalculozica Cholecystitis is an acute inflammatory disease necrotic without gallstones, the gallbladder, the pathogenesis multifactoriala.Aceasta occurs in 10% of cases of acute cholecystitis and is associated with high mortality and morbidity crescur. Risk factors involved in its etiology, are: -Major diseases: burns, surgery, sepsis, trauma The shock- -Immunodeficiency -Vasculitis. Pathogenic mechanism involving the release of mediators of inflammation due to ischemia, infection or stasis biliare.Uneori infectious agent can be identified: Sallmonela or children citomegalus virus.La disease occurs after a severe febrile state without identifying an infectious agent.
Most patients have had repeated attacks of biliary colic or cholecystitis previous acuta.Durerea is the main symptom is similar to that of biliary colic, but it takes more than> 6 hours, and is also severa.Varsatura is often encountered, as well as sensitivity subcostala dreapta.In Murphy sign appears several hours, and involuntary contractions of the lower quadrant drept.Febra present.
Acute cholecystitis in serious decreases in 2-3 days and resolves in a week in 85% of cases. Without treatment, 10% of patients will develop local perforation, and 1% free perforation and peritonitis. Treatment includes hospitalization, hydro-dynamic rebalancing, opioide.Terapia analgesia with NSAIDs or parenteral antibiotic is initiated to prevent infectious ncomplicatiile. Cholecystectomy pain and decreases healing acute cholecystitis preferred biliara.Este establishing how the surgery earlier.

Causes and pathogenesis The main cause of the outburst is acalculozice cholecystitis and biliary stasis bile litogenice.Pacientii increase in critical condition are more likely due to increased bile viscosity in the mouth and dehydration, and lack of oral nutrition resulting in a prolonged decline or absence of cholecystokinin-induced contraction of gall. gallbladder wall ischemia that occurs in fever, dehydration or heart failure also plays a role in the pathogenesis of cholecystitis acalculozice.