Edit concept Question Editor Create issue ticket

Pericholecystic Abscess


Presentation

  • METHOD: Data were retrospectively collected from clinical case notes and a literature review is presented.[ncbi.nlm.nih.gov]
  • Presentation Nausea, vomiting, and epigastric pain. Refers medical care for about 10 days for the same symptoms. Patient Data Age: 66 Gender: Female Loading images...[radiopaedia.org]
  • Home OSTMED-DR Hypersplenism secondary to a ruptured gallbladder and a pericholecystic abscess that presented as...[ostemed-dr.contentdm.oclc.org]
  • The Consulting Editor of Radiologic Clinics, Frank Miller, presents a comprehensive review of Adult Body MR.[books.google.com]
  • Yeh Oxford University Press, 2015 - 760 من الصفحات Gastrointestinal Imaging presents a comprehensive review of gastrointestinal pathologies commonly encountered by practicing radiologists and residents in training.[books.google.com]
Fever
  • Grande-Pérez, Jaqueline de Jesus Pereira, Fellippo Ramos Published in Revista espanola de enfermedades digestivas… 2009 A 75-year-old male patient with recurrent biliary colics attends the emergency service because of right upper-quadrant abdominal pain and fever[semanticscholar.org]
  • Expect fever to resolve in 24 hours and diarrhea within 4-5 days [NEJM 346: 334, 2002].[openanesthesia.org]
  • He was hypotensive and had high fever. On physicalexamination lockalized tenderness in the right upper quadrant was noted. CT-scanrevealed a cholecystitis complicated by an perihepatic abscess with impression onthe gastric wall.[docslide.com.br]
  • Presence of fever and leukocytosis in acute cholecystitis. Ann Emerg Med 1996; 28: 273. PMID: 8780469 Jain A et al. History, physical examination, laboratory testing and emergency department ultrasonography for the diagnosis of acute cholecystitis.[coreem.net]
  • Acalculous cholecystitis may present similiarly, but often present w/ fever and sepsis alone Elderly (esp. elderly w/ DM) may present w/o pain or fever Localized tenderness may not be present or be the only sign May progress to complicated cholecystitis[fprmed.com]
Cape Verde
  • Verde","region_id":1},{"id":126,"name":"Cayman Islands","region_id":1},{"id":43,"name":"Central African Republic","region_id":1},{"id":217,"name":"Chad","region_id":1},{"id":48,"name":"Chile","region_id":1},{"id":50,"name":"China","region_id":1},{"id[radiopaedia.org]
Abdominal Pain
  • Grande-Pérez, Jaqueline de Jesus Pereira, Fellippo Ramos Published in Revista espanola de enfermedades digestivas… 2009 A 75-year-old male patient with recurrent biliary colics attends the emergency service because of right upper-quadrant abdominal pain[semanticscholar.org]
  • A 75-year-old male was admitted to the hospital because of a sudden onset of right upper abdominal pain after a lunch. Abdominal CT scan findings of the gallbladder performed preoperatively had a strange shape which seemed like a record disk.[jlc.jst.go.jp]
  • Pain Diagnostic Strategies 411 513 Imaging 413 514 Conclusion 429 References 431 Imaging of Acute Intestinal Obstruction 434 523 Diagnosis of Site 437 525 Diagnosis of Complications 446 526 Impact and Diagnostic Strategy 449 References 450 Imaging and[books.google.com]
  • Severe abdominal pain referred to the patient's back, nausea, vomiting, and high serum and urinary amylase values were compatible with acute pancreatitis.[link.springer.com]
Left Lower Quadrant Pain
  • Articles will include: Evaluating the patient with right upper quadrant pain; Evaluating the patient with left upper quadrant pain; Evaluating the patient with right lower quadrant pain; Evaluating the patient with left lower quadrant pain; Acute pancreatitis[books.google.com]
Left Upper Quadrant Pain
  • Articles will include: Evaluating the patient with right upper quadrant pain; Evaluating the patient with left upper quadrant pain; Evaluating the patient with right lower quadrant pain; Evaluating the patient with left lower quadrant pain; Acute pancreatitis[books.google.com]
Tachycardia
  • […] ulcer)吻合部潰瘍 subacute bacterial endocarditis 亜急性細菌性心内膜炎 subacute hepatic necrosis亜急性肝壊死 submucosal layer粘膜下層 superficial gastritis表層性胃炎 superior mesenteric artery syndrome (arteriomesenteric occlusion of duodenum)上腸間膜動脈症候群 suppository坐薬 swallowing嚥下運動 t tachycardia[tokyo-med.ac.jp]
Murphy's Sign
  • The patient experiences pain when palpated on the right hypochondrium, with Murphy’s sign and a temperature of 38 oC.[semanticscholar.org]
  • Cholelithiasis, sonographic Murphy sign, and GB wall thickening • CT findings Distended GB (measuring 5 cm in short axis) GB wall thickening ( 3 mm) with mural and mucosal hyperenhancement and pericholecystic fat stranding Calcified gallstones may be[clinicalgate.com]
  • sign, jaundice (15%) Murphy's sign had highest specificity (79-96%) but low sensitivity (20-87.5%) Absence of physical findings does not r/o cholecystitis Elderly and DM may present w/ vague signs, localized tenderness may or may not be present Abd/GI[fprmed.com]
  • ’s sign) Best test for diagnosis of acute cholecystitis ( Jain 2017 ) ( ) LR 15.64 (-) LR 0.40 Fever is poorly sensitive (35%) and nonspecific (80%) ( Towbridge 2003 ) Diagnostic Test Performance in Acute Cholecystitis (The Resus Room) The Resus Room:[coreem.net]
  • The patient experiences pain when palpated on the right hypochondrium, with Murphy's sign and a temperature of 38 ºC.[scielo.isciii.es]
Biliary Colic
  • Grande-Pérez, Jaqueline de Jesus Pereira, Fellippo Ramos Published in Revista espanola de enfermedades digestivas… 2009 A 75-year-old male patient with recurrent biliary colics attends the emergency service because of right upper-quadrant abdominal pain[semanticscholar.org]
  • Pyelonephritis Presentation History Right upper quadrant (RUQ) pain History of similar, self-limited pain (biliary colic) Nausea/Vomiting Radiation of pain to the tip of the right scapula (referred pain) Physical Examination RUQ/epigastric tenderness[coreem.net]
  • Portugal Case report A 75-year-old male patient with recurrent biliary colics attends the emergency service because of right upper-quadrant abdominal pain and fever for two days.[scielo.isciii.es]
  • colic Stages of Cholecystitis Stage 1 (edematous): 2-4 days; gallbladder tissue intact w/ edema in subserosal layer, interstitial fluid w/ dilated capillaries and lymphatics Stage 2 (necrotizing): 3-5 days; edematous w/ areas of hemorrhage and necrosis[fprmed.com]
  • colic 胆石仙痛 biliary liver cirrhosis胆汁性肝硬変 biliary tract 胆道 bilirubin ビリルビン board-like abdomen 板状硬 bougienageブジー拡張術 bowel movement便通 bowel preparation腸管洗浄 brushing cytology擦過細胞診 c cancer of stomach (stomach cancer)胃癌 carbohydrate antigen (CA) 19-9CA 19[tokyo-med.ac.jp]
Encephalopathy
  • 593 7111 Cerebral Sinovenous Thrombosis and Venous Infarction 594 7112 Arterial Infarction 595 Asparaginase Methotrexate and Cyclosporin 596 7116 EndocrineRelated Encephalopathy 597 Thoracic Emergencies 601 723 Clinical Symptoms 602 724 Imaging of Nontraumatic[books.google.com]
  • Dr Sern Chin Lim Dr International Medical Universitry Malaysia Primary Prophylaxis to Prevent the Development of Hepatic Encephalopathy in Cirrhotic Patients with Acute Variceal Bleeding.[pubfacts.com]
  • […] gram-negative bacilli グラム陰性桿菌 greater curvature大彎 h hamartoma過誤腫 heartburn胸やけ Helicobacter pylori ヘリコバクターピロリ hemangioma血管腫 hematemesis吐血 hematochezia血便 hematuria血尿 hemorrhoid痔核 hepatectomy (hepatic resection)肝切除術 hepatic artery 肝動脈 hepatic coma肝性昏睡 hepatic encephalopathy[tokyo-med.ac.jp]

Workup

Treatment

  • 436 Venous Anatomy 375 437 Image Interpretation 378 438 Interpretive Pitfalls 379 439 Potential Benefits of Combined CTPA and CTV 383 4310 Clinical Results 388 Imaging and Treatment of Thoracic Fluid and Gas Collections 391 443 Imaging Guidance Modalities[books.google.com]
  • Because each type of abscess received differing and successful treatments, the authors' method of classification of US findings seemed to provide a useful way to select the specific therapeutic procedure to achieve optimal results.[ncbi.nlm.nih.gov]
  • Study effectively with content that addresses contemporary medical practice emphasizing physics, clinical evaluation, and treatment following The Joint Commission and the Accreditation Council for Graduate Medical Education.[books.google.com]
  • This success demonstrates that ultrasonography by a real-time scanner can be effective for diagnosis and treatment of acute cholecystitis and pericholecystic abscess.[link.springer.com]

Prognosis

  • Treatment and prognosis Management options for suppurative cholecystitis include both emergent cholecystectomy and percutaneous catheter drainage, also termed percutaneous cholecystostomy (which can later be followed by a cholecystectomy) 1,5-6 .[radiopaedia.org]
  • […] cultures usually positive for bacteria (50-75% of cases), bacterial proliferation may be d/t cholecystitis and not the precipitating factor Cholecystitis usually presents commonly w/ upper abdominal pain and fever, but cannot r/o even if asymptomatic Prognosis[fprmed.com]

Etiology

  • […] of all cases of acute cholecystitis Occurs more often in men As opposed to gallbladder disease in general which occurs more often in women Mostly are elderly patients ( 60) with diabetes Vascular compromise of the cystic artery may play a role in the etiology[learningradiology.com]
  • […] sign • Radiography : Insensitive for detection of ectopic gas • MR : Intraluminal and intramural gas appear as signal voids on all pulse sequences PATHOLOGY • Infection of GB with gas-forming organisms such as Clostridium welchii and Escherichia coli • Etiology[radiologykey.com]
  • […] wall perforations covered up by surrounding tissue forming abscesses Biliary fistula: duodenal-gallbladder fistula formation, usually d/t erosion of wall into duodenum by large stone; stone can travel to ileocecal valve and cause SBO (gallstone ileus) Etiology[fprmed.com]
  • They are difficult to detect clinically, often presenting with fever of unclear etiology. Localized tenderness may be present in as few as 33% of cases, with an abdominal mass in only 10% [Surg Clin North Am 74: 693, 1994].[openanesthesia.org]
  • The youngest patient with gallbladder perforation was a male aged 14 years who had an enteric etiology proven by tissue culture and positive Widal test.[synapse.koreamed.org]

Epidemiology

  • Incidence/Prevalence No large epidemiological study to date, but estimated 10% US pop has gallstones Up to 12% develop acute cholecystitis (most frequent complication of gallstones) after 5-7 yrs Up to 6% develop severe acute cholecystitis Prevalence[fprmed.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Cystic duct obstruction is the proximate cause of cholecystitis Obstruction leads to gallbladder distension An inflammatory reaction occurs due to either mucosal ischemia from increased hydrostatic pressure or cytotoxic effects of bile[coreem.net]
  • This complication occurs in 2-10% of cases of acute cholecystitis. (1) With the increase in cholecystectomies in modern surgical practice, gallbladder perforation is becoming rare with a reported incidence of 0.8%. (2) The pathophysiology leading to perforation[appliedradiology.com]
  • The exact pathophysiologic mechanism leading to oedema of the gallbladder wall in these diverse conditions is uncertain, but it is likely due to elevated portal venous pressure, elevated systemic venous pressure, decreased intravascular osmotic pressure[radiologyassistant.nl]
  • […] ulceration/perforation), prognosis worsens May require surgical intervention Initial mgmt of acute cholecystitis includes bowel rest, IV hydration, and Abx Outpatient therapy if uncomplicated If surgery is required: laparoscopic cholecystectomy is standard Pathophysiology[fprmed.com]

Prevention

  • Dr Sern Chin Lim Dr International Medical Universitry Malaysia Primary Prophylaxis to Prevent the Development of Hepatic Encephalopathy in Cirrhotic Patients with Acute Variceal Bleeding.[pubfacts.com]
  • On the contrary, the indications for such intervention are always widening, as its risks become always smaller and the requirements for prevention higher.[books.google.ro]
  • Relapses occur in 25% of cases, but 75% of these will respond to the same antibiotic if repeated [Lancet ID 5: 549, 2005] Prevention of C.difficile Prevention is primarily by rational antibiotic use and possibly the use of probiotics (in one study, 1[openanesthesia.org]
  • The gallbladder neck is usually obstructed by a calculus (or rarely from a malignant mass such as an underlying cholangiocarcinoma ) which prevents pus from draining through the cystic duct 5 .[radiopaedia.org]
  • Treatment A healthy diet can help prevent gallstones, a common cause of cholecystitis. A patient with cholecystitis will be hospitalized, and they will probably not be allowed to consume any solid or liquid foods for some time.[medicalnewstoday.com]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!