Cholecystitis Case Study
Cholecystitis is inflammation of the gallbladder that can be classified as acute or chronic (Huether & McCance, 2012). However, whether it be acute or chronic both forms are caused by a gallstone, solid components of bile, occluding the cystic duct. Moreover, gallstones can be classified as pigment gallstones and cholesterol stones. Pigment gallstones occur when unconjugated pigments in the bile precipitate and turn in to stones (Huether & McCance, 2012). On the other hand, the majority of cholecystitis cases are caused by cholesterol stones, which results when bile becomes supersaturated with cholesterol and precipitates to form stones (Huether & McCance, 2012). Furthermore, when the gallstone occludes the cystic duct it obstructs bile outflow
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and as a result the gallbladder may become distended and inflamed causing pressure against the distended wall of the gallbladder. The increase in pressure causes a decrease in blood flow and if prolonged can lead to ischemia, necrosis, and perforation of the gallbladder. If this pathophysiologic process continues it can lead to chronic cholecystitis which can result in reflux of bile into the pancreatic duct, then resulting in acute pancreatitis. (Huether & McCance, 2012)
Patient’s with cholecystitis can experience a variety of different symptoms that can range from inflammation, pain, rebound tenderness, and rigidity of the right upper abdominal quadrant that may radiate towards the mid-sternal area of the right shoulder (Huether & McCance, 2012).
In addition, it can also be accompanied with nausea, vomiting, fever, leukocytosis, and abdominal muscle guarding (Huether & McCance, 2012). In the case of client M.E., when she first was admitted by the emergency department she displayed abdominal pain and rebound tenderness in the right upper abdominal quadrant. Additionally, she was experiencing some nausea; however, her abdomen was non-distended, and assessment findings revealed her having a body temperature within defined limits. In addition, her laboratory findings indicated a high white blood cell count, which is a common finding associated finding with cholecystitis due to the pathophysiological process explained above. Though, in order to confirm client M.E.’s medical diagnosis of cholecystitis, and abdominal ultrasound was ordered. Results of the abdominal ultrasound illustrated a distended gallbladder with gallstones measuring up to 1.7 cm, which in fact confirmed the diagnosis of
cholecystitis.
and as a result the gallbladder may become distended and inflamed causing pressure against the distended wall of the gallbladder. The increase in pressure causes a decrease in blood flow and if prolonged can lead to ischemia, necrosis, and perforation of the gallbladder. If this pathophysiologic process continues it can lead to chronic cholecystitis which can result in reflux of bile into the pancreatic duct, then resulting in acute pancreatitis. (Huether & McCance, 2012)
Patient’s with cholecystitis can experience a variety of different symptoms that can range from inflammation, pain, rebound tenderness, and rigidity of the right upper abdominal quadrant that may radiate towards the mid-sternal area of the right shoulder (Huether & McCance, 2012).
In addition, it can also be accompanied with nausea, vomiting, fever, leukocytosis, and abdominal muscle guarding (Huether & McCance, 2012). In the case of client M.E., when she first was admitted by the emergency department she displayed abdominal pain and rebound tenderness in the right upper abdominal quadrant. Additionally, she was experiencing some nausea; however, her abdomen was non-distended, and assessment findings revealed her having a body temperature within defined limits. In addition, her laboratory findings indicated a high white blood cell count, which is a common finding associated finding with cholecystitis due to the pathophysiological process explained above. Though, in order to confirm client M.E.’s medical diagnosis of cholecystitis, and abdominal ultrasound was ordered. Results of the abdominal ultrasound illustrated a distended gallbladder with gallstones measuring up to 1.7 cm, which in fact confirmed the diagnosis of
cholecystitis.