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6 Cards in this Set
- Front
- Back
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Cholecystitis: H&P:
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Unrelenting RUQ pain or tendernessFever
Nausea/vomiting Painful palpable gallbladder in 33% Positive Murphy’s sign Right subscapular pain (referred) Epigastric discomfort (referred) |
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Cholecystitis: H&P: risk factors for gallstone formation:
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The “four Fs”:
Female Fat Forty Fertile (multiparity) |
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Cholecystitis: labs
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Increased WBC; may have:
Slight elevation in alkaline phosphatase, LFTs Slight elevation in amylase, T. Bili |
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Cholecystitis imaging:
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U/S: findings on ultrasound:
Thickened gallbladder wall (3 mm) Pericholecystic fluid Distended gallbladder Gallstones present/cystic duct stone Sonographic Murphy’s sign (pain on inspiration after placement of ultrasound probe over gallbladder) |
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Cholecystitis: Differential Diagnosis:
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Cholangiocarcinoma
Lymphadenopathy Metastatic tumor Gallbladder carcinoma Sclerosing cholangitis Gallstones Tumor embolus Parasites Postsurgical stricture Hepatoma Benign bile duct tumor |
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Cholecystitis: management and intervention:
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IVFs, ABXs, lap Chole:
1. Dissection of peritoneum overlying the cystic duct and artery 2. Clipping of cystic artery and transect3. Division of cystic duct between clips 4. Dissection of gallbladder from the liver bed 5. Cauterization; irrigation; suction, to obtain hemostasis of the liver bed 6. Removal of the gallbladder through the umbilical trocar site |
