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Cholecystitis
Otje Hudaja, dr., SpB
Roys Pangayoman, dr. SpB
Definition
Acute inflammatory process in
the gallbladder in the absence of
gallstones or any other form of
obstructive pathology at the
gallbladder outlet.
Pathogenesis
Diagnosis
Clinical syndrome is similar to acute
calculous cholecystitis, but usually
diagnosis is frequently delayed or more
frequently made only at surgery.
(However, all of acute acalculous
patients in Immanuel Hospital were all
diagnosed preoperatively)
Upper abdominal pain, tenderness,
palpable distended gallbladder.
USG sensitivity and specificity 50%100%.
Treatment
Semiemergency or emergency surgical
treatment (early surgery) is advocated.
Best performed with perioperative
broad spectrum antibiotic cover,
probably also include antianaerobe.
Laparotomy, establishment of diagnosis
and cholecystectomy.
Statistical Results
Male: 5 patients ; Female: 2 patients
Age Oriented
Number of patients
4
3
2
1
0
0-10
10-20
21-30
31-40
Years old
41-50
51-60
> 60
Chief Complaint
1
1
Epigastic pain
Pain at RUQ
Abdominal pain
Unknow n
Pathological Findings
Acute cholecystitis
gangrenous
Acute cholecystitis
Acute cholecystitis
aspesifik
0
3
Number of Cases
Pre-surgical diagnosis
Number of cases
0
Acute
Cholelithiasis
Acute
cholecystitis
appendicitis
Gastritis
Unknown
Other Results
ALL Acute Acalculous patients were
conducting Open Cholecystectomy.
Only 2 patients were found with
perforation as complication.
Comparison Study
from other Researchers
Hottenrott, Ch., Mokler P., Paolucci, V.(1991):
Zusammenfassung:
Die akute Cholezystitis bedarf der raschen klinischen
Sicherung. Nach kurzer Optimierung des Patienten ist
die mglichst frhe Cholezystektomie anzustreben.
Diese sollte bei entsprechender Erfahrung grundsatzlich
laparoskopisch versucht werden. Erste diesbezugliche
Ergebnisse lassen eine weitere Verbesserung der
Chancen dieser Patienten aufgrund der schonenderen
Vorgehensweise erwarten.
Wanita
Pria
Jumlah
11-20
22.22
21-30
22.22
31-40
33.34
41-50
11.11
51-60
11.11
Jumlah
100
Kolesistitis
akut
No.
Keluhan
nyeri
Akalkulosa
Kalkulosa
Kasus
Kasus
Test
Statistik
RUQ
100
35
100
Not
sign.
Tekan
RUQ
100
35
100
Not
sign.
Epigastrium
22.22
14.3
Not
sign.
Murphys
sign
100
35
100
Not
sign.
THanK yOu