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Acute Cholecystitis is a medical condition, in which gallbladder’s wall becomes inflamed, and is usually caused by a gallstone in the cystic duct, that results in an attack of abrupt severe pain. At least 95% of the patients with Acute Cholecystitis have gallstones. In very rare cases, a bacterial infection results in inflammation. Acute Cholecystitis starts with sudden, sharp pain in the upper abdomen. In most cases this medical condition is very severe and may cause perforation of the gallbladder or gangrene. Prompt surgery is needed to remove the diseased gallbladder. The symptoms of acute cholecystitis include pain in the right upper area of the abdomen and it is a 1st sign of inflammation of the gallbladder. The pain may become worse when a patient is breathing deeply and frequently extends to the lower area of the right shoulder blade. Vomiting and nausea are common. A patient usually experiences sharp pain when a physician presses the upper right area of the abdomen. During a several hours, the muscles of the abdomen on the right side can become rigid. At beginning, the patient can have only slight temperature, but later it tends to become high. Usually Acute Cholecystitis attack is subsiding in two or three days and fully disappears in 7 days. If it does not, the individual can have severe complications such as high fever, gangrene, gallbladder perforation, shivering, and others. Prompt surgery is required for these conditions. Acute Cholecystitis usually accompanied by jaundice or a backup of bile into the liver, showing that the common bile duct can be partially obstructed by inflammation or gallstone. If blood tests determine a higher level of the enzyme amylase, a patient can have pancreatitis (pancreas inflammation), resulted from gallstone obstruction of the pancreatic duct. Diagnosis of Acute Cholecystitis depends on the patient’s symptoms and the results of specific tests. Ultrasound scan may help to determine the presence of gallstones in the gallbladder and may show thickening of the wall of gallbladder. The procedure called Hepatobiliary Scintigraphy provides more accurate diagnosis. In this test, images of liver are taken, as well of galbladder, upper portion of the small intestine and bile ducts. A patient with Acute Cholesystitis usually is hospitalized, getting intravenous electrolytes and fluids, and not permitted eat or drink. Physician can pass a tube through the nose and into the stomach, so that suctioning may be used to maintain stomach empty and thus reduce gallbladder stimulation. Antibiotics are given as soon as Acute Cholecystitis is suspected. If the diagnosis of acute gallbladder inflammation is confirmed and the risk of operation is small, the gallbladder is usually taken out within 1 or 2 days of the disease, but if a patient has another disease that increases the surgery’s risk, the operation can be delayed until that illness is treated. If Acute Cholecystitis attack subsides, the gallbladder can be taken out later approx after 1 1/2 months or more. If such side effects like gangrene, gallbladder perforation, abscess occur, prompt surgery is usually required. Some individuals have recurring or new incidences of pain that feel like Acute Cholesystitis attack even though they have no gallbladder. The cause of these incidences is unknown, but they cab be caused by a defected function of the sphincter of Oddi - the opening, that releases bile into the small intestine. Pain is suggested to be caused by increased pressure in the duct resulted from resistance to the bile flow or secretions of pancreatis. In some individuals, small gallstones, which are remains after operation, can result in pain. Physician may use an endoscope to widen the sphincter of Oddi. This procedure generally relieves symptoms in patients with abnormal sphincter, but does not help people who only experience the pain.
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