Cholecystitis

Inflammation of the gallbladder, a tiny organ located next to the liver that aids in food digestion, is known as cholecystitis. Ordinarily, bile exits the gallbladder and travels to the small intestine. Bile accumulates inside the gallbladder if the flow is obstructed, resulting in pain, edema, and perhaps even an infection.

Cholecystitis is typically brought on by gallstones that are blocking the tube that exits your gallbladder. Bile accumulates as a result, which may result in inflammation. In addition to this, tumors and bile duct issues can also result in cholecystitis.

Causes

• Gallstones: Gallstones, which are solid deposits that form in your gallbladder as a result of imbalances in bile salts and cholesterol, are the main cause of cholecystitis. Gallstones can obstruct the cystic duct, which is the tube through which bile exits the gallbladder, causing bile to build up and inflaming the surrounding tissue.
• Tumor: A tumor may obstruct your gallbladder's normal bile flow, resulting in bile accumulation that can cause cholecystitis.
• Bile duct blockage: Cholecystitis can result from bile duct blockages brought on by kinking or scarring of the ducts.

Symptoms

• Pain under right shoulder blade
• Fever
• Nausea
• Upper right-side abdominal pain
• Biliary colic after a fatty meal
• Vomiting
• Gas
• Jaundice
• Shrinking or thickening of gallbladder
• Gallbladder inflammation
• Back pain
• Itching skin
• Pale stool
• Indigestion

Diagnosis

• Lab evaluations: CBC, Lipase, Amalyse, Bilirubin, and LFTs (Liver function tests).
• belly ultrasound.
• Internal CT.
• Stomach X-ray.
• Cholecystogram.
• A HIDA scan, which can monitor bile production and flow from the patient's liver to the small intestine, will reveal any obstructions. It does involve injecting radioactive dye into the body for this scan.

Treatment

• Fasting. Initially, you might not be permitted to eat or drink anything to relieve the pressure on your inflamed gallbladder. You might get fluids through a vein in your arm to prevent dehydration.
• Infection-fighting antibiotics In the event that your gallbladder is infected, your doctor will probably suggest antibiotics.
• medicines for pain. These can aid in pain management till the gallbladder inflammation is reduced..
• Most frequently, a tiny video camera attached to the end of a flexible tubing is used during cholecystectomy. This enables your physician to access the interior of your belly and remove the gallbladder using specialized surgical equipment (laparoscopic cholecystectomy). Four abdominal incisions are made to implant the instruments and camera, and the surgeon will use a monitor to guide the tools while performing surgery. Rarely is an open operation necessary, which involves making a lengthy incision in your abdomen.
• A less invasive method of gallbladder removal is being researched. The procedure, also referred to as natural orifice transluminal endoscopic surgery (NOTES), aims to reduce discomfort and scarring. While laparoscopic cholecystectomy is still the gold standard for gallbladder removal, NOTES is being practiced in a small number of centers globally and may eventually play a significant role.

Nursing Management

• Using the relevant pain scale, determine the level of pain. 30 minutes before and 30 minutes after taking a painkiller, evaluate your pain.
• administer painkillers as directed and necessary.
• Every four hours or as needed, check your vital signs, including your temperature. Inform the medical professional about any unusual findings.
• Every 4-6 hours, evaluate the patient's mental state and level of consciousness. Changes in mental state, disorientation, or any decline from the baseline can indicate infection.
• Any abnormal laboratory results, such as a high WBC count, should be reported and noted to the healthcare professional.
• Encourage the patient to keep a limited amount of activity and bed rest. This will lessen pancreatic pain and secretions.
• Use non-pharmacological techniques to help you manage your discomfort.

References

• http://www.curediseasecouncil.com/chronic-gallbladder-disease-symptoms-cholecystitis-overview-webmd.html
• www.webmd.com/digestive-disorders/tc/cholecystitis-overview
• www.mayoclinic.org/diseases-conditions/cholecystitis/basics/causes/con-20034277
• grandrapidsobgyn.com/health-library/healthwise/?DOCHWID=zw1011spec
• medicaldice.com/diseases-a-z/health/cholecystitis-gallbladder-inflammation/
• www.nchmd.org/education/mayo-health-library/details/CON-20034277
• Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
• https://es.scribd.com/doc/101839585/Chole-Cystitis