Cholecystitis is inflammation of the gallbladder. It occurs when bile becomes trapped in the gallbladder, usually due to gallstones blocking the bile duct. This causes irritation and swelling of the gallbladder. Acute cholecystitis presents with right upper quadrant pain, fever, and leukocytosis. Chronic cholecystitis involves recurring episodes and is associated with scarring and thinning of the gallbladder tissues. Risk factors include obesity, rapid weight loss, family history, female gender, and certain diets. Treatment involves managing symptoms, identifying the underlying cause, preventing complications, and educating patients.
Cholecystitis is inflammation of the gallbladder. It occurs when bile becomes trapped in the gallbladder, usually due to gallstones blocking the bile duct. This causes irritation and swelling of the gallbladder. Acute cholecystitis presents with right upper quadrant pain, fever, and leukocytosis. Chronic cholecystitis involves recurring episodes and is associated with scarring and thinning of the gallbladder tissues. Risk factors include obesity, rapid weight loss, family history, female gender, and certain diets. Treatment involves managing symptoms, identifying the underlying cause, preventing complications, and educating patients.
Cholecystitis is inflammation of the gallbladder. It occurs when bile becomes trapped in the gallbladder, usually due to gallstones blocking the bile duct. This causes irritation and swelling of the gallbladder. Acute cholecystitis presents with right upper quadrant pain, fever, and leukocytosis. Chronic cholecystitis involves recurring episodes and is associated with scarring and thinning of the gallbladder tissues. Risk factors include obesity, rapid weight loss, family history, female gender, and certain diets. Treatment involves managing symptoms, identifying the underlying cause, preventing complications, and educating patients.
Cholecystitis is inflammation of the gallbladder. It occurs when bile becomes trapped in the gallbladder, usually due to gallstones blocking the bile duct. This causes irritation and swelling of the gallbladder. Acute cholecystitis presents with right upper quadrant pain, fever, and leukocytosis. Chronic cholecystitis involves recurring episodes and is associated with scarring and thinning of the gallbladder tissues. Risk factors include obesity, rapid weight loss, family history, female gender, and certain diets. Treatment involves managing symptoms, identifying the underlying cause, preventing complications, and educating patients.
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CHOLECYSTITIS
DISEASE Cholecystitis is defined as gallbladder inflammation. It comes from the Greek word "cholecyst" which means "gallbladder" and the suffix "itis" which indicates inflammation. It happens when a digestive juice called bile gets trapped in your gallbladder. The gallbladder is a small organ under your liver. It stores bile which is made in the liver. Normally bile drains out of your gallbladder and into your small intestine. If the bile is blocked, it builds up in your gallbladder. This causes inflammation and can cause infection. Cholecystitis can be sudden (acute) or long-term (chronic). Acute cholecystitis (AC) is a stone obstruction that leads to bile trapping, increased intraluminal pressure, and an acute inflammatory process, typically presenting with RUQ (Right upper quadrant) pain, leukocytosis, and fever. Chronic cholecystitis is defined as recurrence of these events and is associated with fibrosis and mucosal atrophy. Acalculous cholecystitis is considered in chronically debilitated patients, classically elderly patients in ICU on total parental nutrition after sustained trauma or significant burn injury. Ascending (or acute) cholangitis is an important complication of cholecystitis – a serious bacterial infection of the common bile duct. It presents Charcot’s triad of fever, jaundice, and abdominal pain (Peach, 2021). Gallstones affect 10 - 20% of Americans, and up to one-third of these persons get cholecystitis. In contrast, Indian and Scandinavian individuals have the highest prevalence of cholecystitis, which diagnosed 20.5 million people (about the population of New York) in 2012 and resulted in nearly 7,000 deaths. In the same year, there were up to 636,000 hospitalizations and over 500,000 cholecystectomies. In 2011, the disease impacted 5,073, 040 persons in the Philippines alone. In general, the frequency of cholecystitis rises with age, and females are 2-3 times more likely than males (Arch, 2015). CAUSES Cholecystitis happens when a digestive juice called bile gets trapped in your gallbladder. In most cases, this happens because lumps of solid material (gallstones) are blocking a tube that drains bile from the gallbladder. When gallstones block this tube, bile builds up in your gallbladder. This causes irritation and pressure in the gallbladder. It can cause swelling and infection. Other causes of cholecystitis include; Bacterial infection in the bile duct system. The bile duct system is the drainage system that carries bile from your liver and gallbladder into the first part of your small intestine (the duodenum). Tumors of the pancreas or liver. A tumor can stop bile from draining out of your gallbladder. Reduced blood supply to the gallbladder. This may happen if you have diabetes. Gallbladder sludge. This is a thick material that can’t be absorbed by bile in your gallbladder. The sludge builds up in your gallbladder. It happens mainly to pregnant women or to people who have had a very fast weight loss. In most cases, an attack of cholecystitis lasts 2 to 3 days. Each person’s symptoms may vary. Symptoms may include; Persons with gallbladder disease have few or no symptoms. Others, however, will eventually develop one or more of the following symptoms: (1) Frequent bouts of indigestion, especially after eating fatty or greasy foods, or certain vegetables such as cabbage, radishes, or pickles, (2) Nausea and bloating (3) Attacks of sharp pains in the upper right part of the abdomen. This pain occurs when a gallstone causes a blockage that prevents the gallbladder from emptying (usually by obstructing the cystic duct). (4) Jaundice (yellowing of the skin) may occur if a gallstone becomes stuck in the common bile duct, which leads into the intestine blocking the flow of bile from both the gall bladder and the liver. This is a serious complication and usually requires immediate treatment. RISK FACTORS Risk factors associated with development of gallstones include heredity, Obesity, rapid weight loss, through diet or surgery, age over 60, Native American or Mexican American racial makeup, female gender- gallbladder disease is more common in women than in men. Women with high estrogen levels, because of pregnancy, hormone replacement therapy, or the use of birth control pills, are at particularly high risk for gallstone formation, Diet-Very low-calorie diets, prolonged fasting, and low-fiber /high-cholesterol/high- starch diets all may contribute to gallstone formation. PATHOPHYSIOLOGY
NURSING CARE PLAN
Patient Jones was admitted on March 17, 2015, with a chief complaint of fever (low grade). Upon assessment of Patient's past and present history, patient claims that he is a healthy and active man, usually smokes occasionally and drinks alcohol in a casual setting. Patient demands of foods that are acidic despite being instructed by NPO. Upon occurrence of condition, he expressed "pan-oy", yet on the day of the assessment, he expressed that he is feeling well, even expressing it with a mischievous smirk. At 8AM of March 19, 2015, he was referred for ultrasound at Miranda Family Hospital.
ON -Patient is a healthy -Low-grade fever 1.Reduce fever and 1.Monitor vital 1.Patient's fever is and active man with -Possible maintain normal signs, including reduced and a history of underlying body temperature. temperature, maintains a occasional smoking medical condition 2.Identify and treat every 4 hours. normal body and social drinking. causing fever the underlying 2.Administer temperature. -Patient was -Possible acidic cause of the fever. antipyretics as 2.The underlying admitted with a low- food intolerance 3.Prevent needed to reduce cause of the fever grade fever. complications from fever. is identified and -Patient has a the fever or 3.Encourage fluid treated. history of underlying medical intake to prevent 3.The patient does demanding acidic condition. dehydration. not experience foods despite being 4.Educate the 4.Provide a cool any complications instructed on NPO patient about the environment to from the fever or status. importance of promote comfort. underlying -Patient expressed following NPO 5.Apply cool medical condition. feeling "pan-oy" instructions. compresses to the 4.The patient is upon admission but 5.Provide comfort forehead and compliant with now claims to be and support to the neck. NPO instructions. feeling well. patient. 6.Review the 5.The patient is -Patient was referred patient's medical comfortable and for ultrasound at history and satisfied with the Miranda Family perform a care he is Hospital on March physical receiving. 19, 2015. Diagnosis examination to identify the underlying cause of the fever. 7.Discuss the patient's diet with a nutritionist to develop a plan that will prevent acidic food intolerance. 8.Provide patient education about the importance of following NPO instructions. 8.Offer emotional support and reassurance to the patient.
REFERENCES
Case of cholecystitis (Peach, 2021) Medical Student Clinical Pearl
https://sjrhem.ca/a-case-of-cholecystitis-medical-student-clinical-pearl/? fbclid=IwAR1lQHTv1uNi8wVpJ82k5bpMuVl9ehv3V0JQbhDfdo4ZxkRL5S5roozUNgM Cholecystitis Case Study Version 2.0 (Arch, 2015) https://www.scribd.com/document/253795306/CHOLECYSTITIS-CASE-STUDY-Version-2-0- docx?fbclid=IwAR1_J_vD- heWSEvMH0ALngpUANFHImzMM9JUc9_Js0mkpfOhIKuYklD1lSY
