obsolete calculus of gallbladder with acute cholecystitis, with obstruction

Obstructive Calculus Gallbladder Disease

The obstructive form of calculus gallbladder disease occurs when a gallstone or biliary sludge blocks the cystic duct, leading to inflammation of the gallbladder. This condition is also known as acute calculous cholecystitis (ACC).

• Symptoms: The symptoms of ACC can vary in severity and may include:
  • Abdominal pain
  • Fever
  • Nausea and vomiting
  • Jaundice (yellowing of the skin and eyes)
  • Loss of appetite
• Causes: The obstruction of the cystic duct by a gallstone or biliary sludge is the primary cause of ACC. This can lead to inflammation of the gallbladder, which can become distended and thickened.
• Complications: If left untreated, ACC can lead to serious complications, including:
  • Gangrenous cholecystitis (death of tissue in the gallbladder)
  • Perforation of the gallbladder
  • Abscess formation
  • Sepsis

Diagnostic Tests

Several diagnostic tests can be used to confirm the diagnosis of ACC, including:

• Abdominal X-ray: An abdominal X-ray can be used to identify calcified gallstones.
• CT scan: A CT scan can show signs of inflammation and obstruction in the gallbladder.
• Ultrasound: An ultrasound can also be used to diagnose ACC.

Treatment

The treatment for ACC typically involves surgical removal of the gallbladder (cholecystectomy). In some cases, endoscopic drainage may be performed to relieve the obstruction. Antibiotics may also be prescribed to treat any underlying infection.

References:

• [1] by L Ansaloni · 2016 · Cited by 552 — Gallstones are common and present as acute calculus cholecystitis (ACC) in 20 % of patients with symptomatic disease, with wide variation in severity.
• [2] by L Ansaloni · 2016 · Cited by 544 — Gallstones are common and present as acute calculus cholecystitis (ACC) in 20 % of patients with symptomatic disease, with wide variation in severity.
• [3] by J Behar · 2006 · Cited by 500 — The obstruction of the cystic duct by a gallstone or biliary sludge is the primary cause of ACC.
• [4] by Sato et al. (2022) — Acute calculous cholecystitis (ACC) accounts for 3–11% of hospital admissions and can lead to serious complications if left untreated.

Symptoms of Obsolete Calculus of Gallbladder with Acute Cholecystitis

The symptoms of obsolete calculus of gallbladder with acute cholecystitis can be severe and may include:

• **Sudden sharp pain in the upper right-hand side of your tummy (abdomen

Based on the search results, it appears that there are several diagnostic tests used to determine gallbladder disease, including:

• Ultrasonography (USG) is the best way to detect gallstones in the gallbladder [9].
• CT scans can create cross-sectional images of your abdomen, allowing doctors to detect gallstones [4].
• MRI scans can also be used to diagnose gallbladder disease [4].
• Laboratory tests such as bilirubin and alkaline phosphatase (ALP) assays are used to evaluate for the presence of common bile duct obstruction caused by gallstones [5].

In cases where there is an obstruction, the following diagnostic tests may be used:

• CT scans can help identify the location and severity of the obstruction [4].
• MRI scans can also be used to diagnose the cause of the obstruction and assess its impact on the surrounding tissues [4].
• Laboratory tests such as complete blood count (CBC) and liver function tests may be performed to evaluate for signs of inflammation or infection [8].

It's worth noting that while these diagnostic tests can help identify gallbladder disease, they are not always 100% accurate. A definitive diagnosis is often made based on a combination of clinical symptoms, imaging test results, and laboratory findings.

References:

[4] CT scans can create cross-sectional images of your abdomen, allowing doctors to detect gallstones. [5] Laboratory tests such as bilirubin and alkaline phosphatase (ALP) assays are used to evaluate for the presence of common bile duct obstruction caused by gallstones. [8] Tests to diagnose cholecystitis may include: Complete blood count (CBC). Liver function tests. [9] Doctors diagnose cholecystitis based mainly on symptoms and results of imaging tests. Ultrasonography is the best way to detect gallstones in the gallbladder.

Based on the search results provided, it appears that there are various treatment options for acute cholecystitis, including drug treatment and surgery.

For drug treatment, antibiotics are often prescribed to prevent or treat infection [1]. Additionally, medications may be used to temporarily control symptoms such as pain and inflammation [2].

However, in cases where the gallbladder is obstructed due to calculus (gallstones), surgical intervention may be necessary. In fact, emergency surgery to remove the gallbladder is often required in about 1 in every 5 cases of acute cholecystitis [3]. This is because the obstruction can lead to severe complications if left untreated.

In most cases, healthcare providers recommend definitive treatment with surgery, which has excellent outcomes for most people [4]. However, critically ill patients who are unfit for surgery may require rescue treatments such as percutaneous or endoscopic gallbladder drainage (GBD) [5].

It's worth noting that the initial treatment for acute cholecystitis often includes bowel rest, intravenous hydration, correction of electrolyte abnormalities, and analgesia [6]. However, in cases with obstruction due to calculus, surgical intervention is usually necessary.

References: [1] - Treatment for calculus of gallbladder with acute cholecystitis · antibiotics to prevent or treat infection [2] - medications to temporarily control ... [3] - In about 1 in every 5 cases of acute cholecystitis, emergency surgery to remove the gallbladder is needed to treat these complications. [4] - In most cases, healthcare providers recommend definitive treatment with surgery. Most people have excellent outcomes. [5] - Critically ill patients, who are unfit for surgery, may require rescue treatments, such as percutaneous or endoscopic gallbladder drainage (GBD) ... [6] - In acute cholecystitis, the initial treatment includes bowel rest, intravenous hydration, correction of electrolyte abnormalities, analgesia, ...

Based on the search results, it appears that the differential diagnosis for acute cholecystitis with obstruction due to an obsolete calculus (gallstone) in the gallbladder is extensive. Here are some possible conditions that may be considered:

• Choledocholithiasis: This refers to a gallstone that has become lodged in the common bile duct, causing obstruction and potentially leading to acute cholecystitis.
• Pancreatitis: Inflammation of the pancreas can sometimes be mistaken for acute cholecystitis, especially if there is associated abdominal pain and tenderness.
• Peptic ulcer disease: A peptic ulcer in the stomach or duodenum can cause symptoms similar to those of acute cholecystitis, including abdominal pain and tenderness.
• Acute hepatitis: Inflammation of the liver can sometimes be mistaken for acute cholecystitis, especially if there is associated jaundice and elevated liver enzymes.
• Liver abscess: A collection of pus in the liver can cause symptoms similar to those of acute cholecystitis, including abdominal pain and tenderness.
• Subhepatic appendicitis: Inflammation of the appendix located near the liver can sometimes be mistaken for acute cholecystitis.

It's worth noting that these conditions may have overlapping symptoms with acute cholecystitis, making differential diagnosis challenging. A thorough medical evaluation, including imaging studies and laboratory tests, is often necessary to determine the correct diagnosis.

References:

• [11] Ultrasound findings similar to those of AC can also be seen in GV (gallbladder wall thickening and pericholecystic fluid).
• [14] The differential diagnosis for acute cholecystitis includes choledocholithiasis, pancreatitis, peptic ulcer disease, acute hepatitis, liver abscess, and subhepatic appendicitis.
• [15] Acute cholecystitis predominantly occurs as a complication of gallstone disease, but can also occur without gallstones (acalculous cholecystitis).