Related articles: Alitiasic cholecystitis
Definition
Alitiasic cholecystitis (improperly referred to as alitiasic gallbladder) is a condition that results from an acute inflammation of the gallbladder (or gallbladder), in the absence of gallstones.
This condition can be favored by the release of enzymes and mediators of the inflammatory process, triggered by biliary stasis, ischemia, infection or atony of the gallbladder wall.
Risk factors that may predispose to alitiasic cholecystitis include severe abdominal trauma, burns, major surgery, prolonged fasting or artificial parenteral nutrition, diabetes mellitus, atherosclerosis, systemic vasculitis (eg lupus erythematosus systemic, polyarteritis nodosa etc.) and acquired immunodeficiency syndromes.
Sometimes an infecting organism (such as Salmonella spp. Or cytomegalovirus in immunosuppressed patients) can be identified as a triggering agent.
Most common symptoms and signs *
- Anorexia
- Asthenia
- Chills
- Bad digestion
- Biliary colic
- Yellow Diarrhea
- Abdominal distention
- Abdominal pain on palpation
- Pain in the upper part of the abdomen
- Temperature
- Flatulence
- Abdominal swelling
- Nausea
- Sweating
- Dark urine
- He retched
Further indications
Alitiasic cholecystitis manifests itself with symptoms similar to those of gall bladder cholecystitis. Therefore, the disease can cause very intense and continuous pain in the upper right part of the abdomen, sometimes accompanied by nausea, lack of appetite and vomiting.
Generally, the pain sensation is similar to that of a biliary colic, but it has longer duration and gravity. The pain is accentuated, then, when one presses on the part and when the person takes deep breaths, sometimes radiating also to the scapula and to the back.
In some cases, abdominal distention or unexplained fever may be the only signs associated with inflammation.
If left untreated, the alitiasic cholecystitis can rapidly progress to the organ gangrene and its perforation, which cause sepsis, shock and peritonitis; mortality, in these cases, approaches 65% of cases.
Typically, the cholecystitis attack requires hospitalization. The diagnosis of acute alitiasic cholecystitis can be placed in the patient who does not have gallstones, but has a positive echographic sign of Murphy or the walls of the gallbladder thickened with a dangerous effusion.
Treatment usually involves the use of antibiotics, antispasmodics and analgesics. In some cases, as soon as the symptoms have improved, we proceed with cholecystectomy, that is the removal of the gallbladder by laparoscopy.
However, if a complication is suspected, such as the formation of an abscess or perforation, it is necessary to intervene surgically.
