Chronic cholecystitis

42,962views

Chronic cholecystitis

Watch later

Watch later

Atrophy, aplasia, and hypoplasia
Metaplasia and dysplasia
Hyperplasia and hypertrophy
Enzyme function
Lipid-lowering medications: Statins
Miscellaneous lipid-lowering medications
Laxatives and cathartics
Protein synthesis inhibitors: Aminoglycosides
Antituberculosis medications
Protein synthesis inhibitors: Tetracyclines
Miscellaneous protein synthesis inhibitors
DNA synthesis inhibitors: Metronidazole
Mechanisms of antibiotic resistance
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Cell wall synthesis inhibitors: Penicillins
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Acetaminophen (Paracetamol)
Antihistamines for allergies
Anatomy of the pharynx and esophagus
Anatomy of the salivary glands
Gallbladder histology
Stomach histology
Colon histology
Pancreas histology
Esophagus histology
Small intestine histology
Liver histology
Gastrointestinal system anatomy and physiology
Liver anatomy and physiology
Anatomy and physiology of the teeth
Enteric nervous system
Gastric motility
Esophageal motility
Chewing and swallowing
Pancreatic secretion
Prebiotics and probiotics
Bile secretion and enterohepatic circulation
Eosinophilic esophagitis (NORD)
Gastric cancer
Celiac disease
Short bowel syndrome (NORD)
Ulcerative colitis
Crohn disease
Gallstone ileus
Familial adenomatous polyposis
Colorectal polyps
Irritable bowel syndrome
Diverticulosis and diverticulitis
Jaundice
Hemochromatosis
Cirrhosis
Cholestatic liver disease
Esophagitis: Clinical
Esophageal disorders: Pathology review
BRUE, ALTE, and SIDS: Clinical
MEN syndromes: Clinical
Abdominal pain: Clinical
Hypertensive disorders of pregnancy: Clinical
Cyclic vomiting syndrome (NORD)
Eating disorders: Clinical
Gastroesophageal reflux disease (GERD)
Gastroesophageal reflux disease (GERD): Clinical
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Esophageal disorders: Clinical
Acid reducing medications
Lipid-lowering medications: Fibrates
Minimal change disease
Non-alcoholic fatty liver disease
Fatty acid synthesis
Fatty acid oxidation
Deep vein thrombosis and pulmonary embolism: Pathology review
Childhood nutrition and obesity: Information for patients and families (The Primary School)
Hunger and satiety
Gallstones
Inflammatory bowel disease: Pathology review
Chronic pancreatitis
Glucagon
Cell membrane
Insulin
Niemann-Pick disease types A and B (NORD)
Metabolic acidosis
Ketone body metabolism
Chronic cholecystitis
Acute cholecystitis
Ascending cholangitis
Pancreatitis: Pathology review
Pancreatitis: Clinical
Bowel obstruction
Jaundice: Pathology review
Gallbladder disorders: Pathology review

Flashcards

Chronic cholecystitis

0 of 9 complete

Questions

USMLE® Step 1 style questions USMLE

0 of 2 complete

A 65-year-old woman comes to a follow-up appointment following hospitalization due to diverticulitis. Since then, she has been recovering well and has no complaints. Medical history is significant for cholelithiasis, hypercholesterolemia, diverticulitis and constipation. Medications include statins, multivitamins, and supplemental fiber. She does not smoke, drink alcohol, or use illicit drugs. On physical examination, the abdomen is soft and nontender, and bowel sounds are present. A CT obtained at the recent hospitalization is shown below and reveals extensive, encrusting calcification of the gallbladder:  


 Reproduced from: ">Wikimedia Commons 
This patient is at risk of developing which of the following complications?  

Transcript

Watch video only

Content Reviewers

With acute cholecystitis, a gallstone gets lodged in the cystic duct, or maybe in the common bile duct, and then causes acute inflammation, pain, and possibly, but not usually, infection; almost all cases of acute cholecystitis though, about 90%, clear up after about a month and the gallstone dislodges.

It’s possible though, that gallstones get stuck again, and then dislodge, and then get stuck again, and dislodge, and so on.

So over time, you can imagine the gall bladder walls taking a serious beating, and as those epithelial cells go through this cycle of inflammation over and over again, patients are essentially in this constant state of inflammation, also known as chronic cholecystitis.

After a while, they can begin to show signs of cellular damage and the epithelial cells can possibly even die off.

Some patients might not even have had cases of acute cholecystitis where the gallstone gets lodged in the ducts, and sometimes they just have gallstones that cause this constant state of irritation and mild inflammation just by being in the gallbladder.

Gallstones can be made up of bilirubin, called pigment gallstones, or cholesterol, called cholesterol stones, or maybe they’re made up of both both, and when they roll around and are in contact with the epithelial cells, they can cause inflammation.

One study found that cholesterol stones in particular might have a more potent ability to stimulate inflammation of the gallbladder epithelial cells.

Whatever the case, chronic inflammation can take its toll, and changes in the gallbladder wall structure can start to take place.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Acute Calculous Cholecystitis" New England Journal of Medicine (2008)
  6. "Diffuse Gallbladder Wall Thickening: Differential Diagnosis" American Journal of Roentgenology (2007)