Acute cholecystitis

Acute cholecystitis

Diagnosis:

Main complaint of patient is pain over right hypochondrium area or may be in epigastrium.

pain is sudden severe colicky pain referring to tip of right shoulder and right scapula.

nausea and vomiting may be present (ask about past history of biliary colic).

by examination → tender gall bladder funds and positive Murphy sign (i.e. →

patient hold breath with pressure on tip of 9^th intercostal space)

NB. → chronic cholecystitis = gall bladder stones = surgical interference.

Investigartion done:

-Sonar → 75% stones.

-X rays upper abdomen → 20%.

-CBC → leucocytosis.

-Minor ↑ in plasma transaminases and amylase.

-May be minor ↑ in serum bilirubin.

-Cholecystography → cystic duct obstruction.

NB. → in 20% only of patients.

Treatment:

1.    Antibiotics (quinolone group)

2.    Drugs for stones

3.    Symptomatic treatment for pain, vomiting, …………

Antibiotics:

-Ciprofar tab.

-Ciprocin tab.

-Rancif tab.

-Tavanic tab.

Drugs for stones:

-Ursochol cap.

-Ursogall cap., susp.

-Rwachol.