CHOLECYSTITIS

Cholecystitis

Pathophysiology:

The gallbladder works in conjunction with the liver to produce and house bile, for use in fat breakdown during digestion. It is common for gallstones to form during this process, and most of us have them to some degree. However if a gallstone manages to occlude the bile duct, pressure inside the gallbladder develops. As this increases, inflammation occurs, leading to pain, nausea, vomiting, and fever.

Clinical presentation:

Patients with cholecystitis present with a combination of the following:

-Nausea

-Fever

-Tachycardia

-Dull, cramping (visceral) pain in the RUQ with exacerbation during palpation (Murphy’s sign)

-Pain with onset 30 min to 1 hour after a fatty meal

Treatment:

-Ensure patent and protected airway

-Assess respirations for adequacy and provide O2 if indicated

-Establish IV access

-Perform 12 lead ECG to rule out cardiac cause for pain

-Provide antiemetic if indicated

-Provide analgesic if indicated

-Provide rapid transport