Gallbladder empyema

Gallbladder empyema

    * Introduction
    * Pathogenesis and causes
    * Signs and symptoms
    * Diagnosis
    * Treatment
Acute cholecystitis bile content in the presence of a bacterial infection may progress to suppurative, the gallbladder fills with purulent material-vesicular condition called empyema. The incidence of acute cholecystitis associated with vesicular empyema is 5-15%.
Rates for conversion of laparoscopic cholecystectomy procedures in open surgery is significantly higher in patients with gallbladder empyema. Rates of complications postinterventionale for empyema is 10-20% and includes wound infection, subhepatic abscess, blockage of the cystic duct, common bile duct injury and septic complications leading to acute renal failure and / or respiratory failure associated with sepsis.
The clinical picture of a patient with empyema of the gallbladder is similar to that of acute cholecystitis. As the disease progresses installs severe pain, fever, chills. Immunocompromised patients with diabetes experiencing fewer symptoms.
Imidiata decompression is the standard for gallbladder empyema. For hemodynamically unstable patients or where surgery is contraindicated because of severe comorbidities, radiological guided transhepatic drainage can cure or consist of a time option.
Early administration of antibiotic therapy in the evolution of empyema, especially ampicillin or a second-generation cephalosporins cause positive results. Spectrum antibiotic is modified by the results of bacterial culture and bacterial resistance.