Part I of II on gallbladder pathology starting with cholecystitis.
Core EM - Emergency Medicine Podcast Episode 117.0 – Acute Cholecystitis
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Oct 16, 2017 This podcast discusses acute cholecystitis, an inflammation of the gallbladder. It covers diagnostic criteria, imaging modalities, and treatment options. Lab tests are not reliable for diagnosis. Treatment includes fluid resuscitation, supportive care, antibiotics, and surgical consultation. Complications can include gangrene, necrosis, perforation, and sepsis.
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Cause And Variants Of Cholecystitis
- Acute cholecystitis is simply acute inflammation of the gallbladder and usually follows cystic duct obstruction.
- Gallstones cause about 95% of cystic duct obstructions while acalculous and emphysematous forms are less common.
Typical Presentation And Fever Limitations
- Presentation often includes right upper quadrant pain, nausea, vomiting, and referred pain to the right scapula.
- Fever is present in only about 35% of patients and is nonspecific.
Use Labs To Screen For Complications
- Don't rely solely on labs to diagnose cholecystitis because they are insensitive and nonspecific.
- Use labs only to look for complications: WBC, mild transaminitis, and bilirubin to suspect choledocholithiasis.