RISK FACTORS

MEDICATIONS GIVEN:

 Bupivacaine HCI, 10 mg
PREDISPOSING FACTORS:
PRECIPITATING FACTORS:  Cefuroxime, 759mg IVTT q 8hrs ANST
Presence of certain gallbladder proteins  Family history
 Eating high-fat diet  Celecoxib, 200mg BID 1xWeek
 Gender (Female)
 High-cholesterol diet
CHOLELITHIASIS  Fentanyl, 50-100 mcg/dose IM
 Dietary habit  Ketorolac, 30 mg IVTT q 6 x 4 doses
 Rapid weight loss DIAGNOSTIC EXAMS PERFORMED:
 nucleation points  Metoclopramide, 10mg IVTT q 8hrs PRN
Super saturation of bile
 CT Scan of whole abdomen  Midazolam
Impaired gallbladder contractility,
Gallbladder hypomotility  ECG  Nalbuphine, 4mg IVTT q 6hrs PRN pain
 CHEST PA  Paracetamol, 900 mg IVTT q 6 c 4 doses to
 HEMATOLOGY: WBC, RBC, start at PACU the D/C
Major constituents
(cholesterol and pigment) ↓mixing of gallbladder contents, PLATELET COUNT  Ranitidine, 50mg tab q 8hrs
↑ residence time for growth within the  Tramadol, 50 mg 1 tab q 6 PRN
gallbladder

Sharp pain in RUQ;

Gallstone in bile duct ja****undice RECURRENT RUQ PAIN
Gallstone migration into biliary tract* Cholecystectomy

Choledocolithiasis Removal of the gallbladder

Bile stasis
Gangrene MUCOCELE* after ligation of the cystic duct
ACUTE PANCREATITIS* 20%*
WEIGHT LOSS
Body will return to normal function
Bacterial proliferation Abnormal fat digestion EMPYGMA*
ASCENDING CHOLANGITIS* Perforation Recovery
Venous and lymphatic Cellular irritation and 20%* MIRIZZI’S SYNDROME*
medical emergency drainage is impaired infiltration might take place dehydration
BILIARY COLIC*
Gallbladder and duct infection CHRONIC CHOLECYSTITIS
Over time, continued inflammation of the
gallbladder can cause complications
Inflammation of gallbladder

Persistent RUQ pain, abdominal guarding, Bacterial invasion →trans mural

CHOLECYSTITIS peritoneal signs, + Murphy’s sign inflammation of the gallbladder

Mechanical and chemical irritation of the Ischemia, gall bladder necrosis, inflammation,
gallbladder’s epithelial mucosa loss of gall bladder structural integrity

↑gallbladder lumen pressure, ↓blood flow to

LEGEND: Acute inflammation of the gall bladder gallbladder
* NOT MANIFESTED BY PT.
DISEASE & COMPLICATIONS
Gallstone blocks bile duct
Diffuse abdominal pain, maybe felt
RUQ pain, fever/ ↑ WBC ACUTE CHOLECYSTITIS Irritation of gall bladder wall more in RUQ, may radiate to the
PATHOLOGY & MECHANISM
Gallstone causing physical back and right shoulder; fever,
SIGNS/SYMPTOMS trauma to gallbladder nausea/vomiting, tachycardic

IF NOT TREATED DEATH