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Cholecystitis

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...

Acute Pancreatitis I: Introduction

Acute Pancreatitis I: Introduction

Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...

Acute Pancreatitis I: Introduction

Acute Pancreatitis I: Introduction

Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:

Appendicitis

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...

Chronic Pancreatitis I: Introduction

Chronic Pancreatitis I: Introduction

The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...

Chronic Pancreatitis I: Introduction

Chronic Pancreatitis I: Introduction

Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80% of...

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Acute acalculous perforated cholecystitis.

Badar Murtaza¹, Imran Bashir Malik, Asad Mahmood

¹Department of General Surgery, Combined Military Hospital, Bahawalnagar Cantt. badar_murtaza@yahoo.com

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|March 10, 2009

Summary

This case report details a middle-aged man with acute acalculous perforated cholecystitis and peritonitis. Despite a moribund presentation, he successfully recovered after emergency surgery and intensive care.

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Area of Science:

Gastroenterology
Surgical Case Reports
Critical Care Medicine

Background:

Acute acalculous cholecystitis is a severe gallbladder inflammation without gallstones.
Perforated cholecystitis with generalized peritonitis presents a surgical emergency.
Cachectic patients often have poorer prognoses and delayed presentations.

Observation:

A middle-aged, cachectic male presented with acute generalized peritonitis secondary to a perforated gallbladder.
The patient was in a moribund state upon arrival.
Emergency laparotomy with subtotal cholecystectomy was performed.

Findings:

The patient developed multi-organ failure post-operatively, requiring intensive management.
Despite the critical condition, the patient showed recovery within approximately two weeks.
Regular follow-up confirmed sustained recovery.

Implications:

This case highlights the possibility of recovery even in critically ill patients with advanced disease.
Prompt surgical intervention and comprehensive critical care are vital for survival.
Late presentation of acute acalculous perforated cholecystitis necessitates aggressive management strategies.