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Acute Cholecystitis by Mind Map: Acute Cholecystitis
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Acute Cholecystitis

Clinical Picture

Symptoms

Fever

Pain, Site, RIGHT HYPOCHONDRIUM, Type, COLICKY, Onset, SUDDEN, Duration, MORE THAN 12 hrs, Radiation, BACK, SHOULDER, RIGHT HYPOCHONDRIUM, LEFT HYPOCHONDRIUM, Precipitating factor, Fatty Food, Movement, Breathing, Relieving Factor, Analgesics

Nausea & Vomiting

Distention & Constipation

Jaundice

Sign

General, TACHYCARDIA, PYREXIA

Local, TENDERNESS - RT HYPOCHONDRIUM, RIGIDITY - RT HYPOCHONDRIUM, MURPHY’S SIGN, BOAS SIGN, MASS

1

Calculus

Obstruct Cystic Duct

Acalculus

Cholesterosis

Cholesterol Polyposis

Cholecystitis glandularis proliferans

Diverticulosis of the gall bladder

Typhoid of Gall Bladder

2

Inflamation

Localization

Ilues

Movement of Omentum

Loops of Intestine

Resolution

Mucocele

Empyema

Perforation

Generalized peritonitis

Local Abcess

Fistula

4

GALL BLADDER RADIONUCLIDE SCAN

BLOOD COMPLETE PICTURE

Leukocytosis

URINE

BILIRUBIN

PLAIN X-RAY ABDOMEN

Radioopaque gall stones

ULTRASONOGRAPHY

Dilatation of billiary tree

Stones

Fluid

ORAL CHOLECYSTOGRAM

Not Used Nowdays

PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY (PTC)

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)

MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP)

Differential Diagnosis

Common

ACUTE PANCREATITIS

PERFORATED DUODENAL ULCER

PERFORATED PEPTIC ULCER

APPENDICITIS

Rare

ACUTE PYELONEPHRITIS

HEPATITIS

MYOCARDIAL INFARCTION

PNEUMONITIS

Complication

MUCOCELE

EMPYEMA

PERFORATION

ABSCESS

PERITONITIS

FISTULA

GALL STONE ILEUS

ACUTE PANCREATITIS

OBSTRUCTIVE JAUNDICE

Management

Conservative treatment

Nasogastric asp., IV fluids, Antibiotics

Antiemetics.

Surgical Treatment

Early ( within 48 hours).

Open/ Lap. Cholecystictomy

Cholecystostomy

Late ( start conservative then surgery)