Ppt on cholecystitiiiiiiiiiiiiiiii iiiii

Cholecystitis

1. CHOLECYSTITIS

2. THE GALL BLADDER
•The gallbladder is a hollow system that sits just beneath the liver.
•In adults, the gallbladder measures approximately 8 centimetres (3.1 in) in
length and 4 centimetres (1.6 in) in diameter when fully distended.
•It is divided into three sections: fundus, body and neck.

4. CAUSES
•Alcohol
•Chronic viral hepatitis- hepatitis B and C
•Biliary Cirrhosis
•Inherited metabolic liver disease (Wilson’s disease)
•Miscellaneous – cystic fibrosis

6. BILE

10. SECRETION OF BILE
Bile is removed by the bile canaliculi (Liver)
That drain into intrahepatic bile duct
Left Duct Right Duct
Common Hepatic Duct
Cystic Duct
Gallbladder for conc. and Storage
Common bile duct
Pancreatic Duct (Ampula of Vater/Sphincter)
Bile get poured into Duodenum

11. CHOLECYSTITIS
(INFLAMMATION OF GALL BLADDER)
•It is cause due to gall bladder stones obstructing the bile duct leading to the back up of
bile
•When biliary tract obstruction
•Prevents bile from reaching intestine
•It back up & reaches to the circulation
•Bilirubin go back to circulation and do jaundice

13. •Impaired Gallbladder emptying in
•Chronic acalculous Cholecystitis Appears
•Due to diminished spontaneous Contractile Activity/decreased contractile response to
CCK
•This leads to gall bladder inflamed and distended
•And lead to inflammation
•Pain in Upper quadrants accompanied with nausea, vomiting
Acute Cholecystitis

14. CHRONIC CHOLECYSTITIS
•Long standing inflammation of gallbladder
•Caused due to repeated mild attack of acute cholecystitis
•It leads to thickening of gallbladder
•It shrinks & actually loss all function
•Eating fatty food---leads to aggravate the function -------because bile regulate the fat digestion
•More common in female, after the age of 40 years
•Risk factors are -----gallstones and Acute Cholecystitis

15. DIAGNOSIS
•Blood test----Markers of inflammation (CBC, CRP, WBC, inc. Bilirubin levels, inc.
aminotransferase)
•Imaging-------Right upper quadrant abdominal ultrasound is done/ CT SCAN
•Surgical Management

16. MEDICAL NUTRITION THERAPY
•Oral Feeding is preferred’
•Low fat Diet------dec. gall bladder stimulation
•A hydrolysed low fat formula or an oral low fat diet constituting 30-45g of fat/day
•Following cholecystectomy may experience symptoms of gastritis--------Add soluble fiber
in the diet
•Will bind the bile into stomach between meals to avoid gastritis