Page 269 - 2021 IDMT Digital

ACUTE CHOLECYSTITIS
Introduction:
• 2YHU RI FDVHV DUH DVVRFLDWHG ZLWK JDOOVWRQHV DFXWH DWWDFN ZKHQ D VWRQH EHFRPHV
LPSDFWHG LQ WKH F\VWLF GXFW DQG LQIODPPDWLRQ GHYHORSV
• $WWDFN LV RIWHQ SUHFLSLWDWHG E\ D ODUJH RU IDWW\ PHDO
• &KDUDFWHUL]HG E\ WKH VXGGHQ DSSHDUDQFH RI VWHDG\ SDLQ LQ WKH 584 RU HSLJDVWULXP

Subjective:
• 6LJQV DQG 6\PSWRPV
o 6WHDG\ VHYHUH SDLQ LQ WKH 584 RU HSLJDVWULXP
o 1DXVHD DQG YRPLWLQJ
o 3DLQ PD\ UDGLDWH WR ULJKW VFDSXOD
• )RFXVHG +LVWRU\
o +LVWRU\ RI JDOOEODGGHU SUREOHPV RU JDOOVWRQHV
o 'LHWDU\ LQWDNH
Objective:
• 3K\VLFDO ([DP
o 9LWDO VLJQV low-grade IHYHU LV common
o 7HQGHUQHVV LQ 584
o 3RVLWLYH 0XUSK\'s VLJQ
o 0XVFOH JXDUGLQJ
o 5HERXQG WHQGHUQHVV
• 7RROV
o /DEV &%& PLJKW VKRZ an HOHYDWHG ZKLWH EORRG FHOO FRXQW OHXNRF\WRVLV
Assessment:
• 'LIIHUHQWLDO
o $SSHQGLFLWLV KLJK-O\LQJ DSSHQGL[ SDLQ LV XVXDOO\ QRW VXGGHQ DQG VHYHUH
o $FXWH KHSDWLWLV LQIHFWLRQ ZLWK hHSDWLWLV $ % & ' ( XVXDOO\ SUHVHQWV ZLWK MDXQGLFH
DQG YLUDO W\SH V\PSWRPV PDODLVH P\DOJLDV QDXVHD YRPLWLQJ
o &KROHOLWKLDVLV JDOOVWRQHV WKDW DUH IUHTXHQWO\ DV\PSWRPDWLF DQG GHWHFWHG ZLWK
XOWUDVRXQG PD\ KDYH ELOLDU\ SDLQ LQ 584 ZLWK UDGLDWLRQ WR WKH VFDSXOD
o $FXWH SDQFUHDWLWLV DEUXSW RQVHW RI GHHS HSLJDVWULF SDLQ RIWHQ ZLWK UDGLDWLRQ WR WKH
EDFN ODEV ZLOO VKRZ HOHYDWHG SDQFUHDWLF HQ]\PHV
o 3HUIRUDWHG SHSWLF XOFHU VXGGHQ LQWHQVH SDLQ RYHU HSLJDVWULXP

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