Diagnosis of Disease

So what is the diagnosis? Diagnosing Cholecystitis is determined by appropriate evaluation of lab values, family history, diet history, physical examination and imaging (ultrasound). One of the most common ways to diagnose the presents of Cholecystitis is using an ultrasound of the abdomen to view whether there is a blockage or the presence of gallstones in the gallbladder. This can also show the thickening of the gallbladder wall indicating inflammation. However, on occasion, the presence of gallstones and the thickened wall of the gallbladder may not be diagnosed. Other tests used for the diagnosis of cholelithiasis and cholecystitis are: Hepatobiliary scintigraphy or cholescintigraphy by hydroxyiminodiacetic acid (HIDA). This scans and determines the functional assessment of gallbladder excretion,  determining if cholecystitis is present. Another test used is a CT scan, magnetic resonance cholangiography (MRCA), and endoscopic retrograde cholangiopancreatography (ERCP) are useful for specific cases.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.





www.ultrasoundcases.info

Etiology/ pathophysiology of Cholecystitis

So what's really wrong when you have Cholecystitis? As I mentioned in an earlier post it is the inflammation of the gallbladder which is usually caused by obstruction (usually gallstones) or otherwise known as Cholelithiasis and causes the wall of the gallbladder to thicken as a result. Any one can get gallstones, it depends mostly on your diet but also could be indicated if you have family history or if your an older women (more prone). Gallstones are composed of crystallized pigment and cholesterol. To get more on a cellular level of the pathophysiology; its the obstruction of the cystic duct where the bile flows through to the duodenum to help digest fats. With the obstruction, this escalates the bile in the gallbladder to stasis leading to a bacterial infection causing the gallbladder to be inflamed. If left untreated, this can quickly escalate to gangrene of the gallbladder and could lead to the rupture of the gallbladder leading to more serious complications as a result: peritonitis, septic shock, empyema or cholecystoenteric fistula.

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.

www.yorksurgeon.com

Epidemiology of Disease- Cholecystitis

Epidemiology or in other words is the contributing factors and this diseases specific commonalities. With this disease specifically, Cholecystitis is estimated to nearly have 10-20% of Americans in the U.S. to have gallstones causing the inflammation. The surgery of removal, Cholecystectomy, is one of the most common surgeries performed annually. About 500,000 operations take place each year. The incidences of Cholecystitis due to gallstones increases more with age and is more common in woman. Race and ethnicity showed a few similarities. There is an increased prevalence among communities of Scandinavian, Pima Indians, and Hispanic heritages. Caucasian's are more prone to cholecystitis than African Americans in the United States.

http://emedicine.medscape.com/article/171886-overview#a6
www.wisegeek.org

What is Cholecystitis?

www.ahealthgroup.com

 

Cholecystitis is defined as an acute inflammation of the gallbladder wall (the green sac). This can be caused by a number of things contributing to it. This usually occurs when obstruction of the cystic duct occurs, causing the bile stored in the gallbladder to become stasis. Most occurrences of cholecystitis is from a blockage of some sort, acalculous cholecystitis (gallstones), or a bacterial infection. 

Copstead-Kirkhorn, Lee-Ellen, Jacquelyn Banasik. Pathophysiology, 5th Edition. W.B. Saunders Company, 2014. VitalBook file.