Disorders in Accessory Organs

CHOLECYSTITIS (CHOLELITHIASIS)
- Acute or chronic
inflammation (cholecystitis)
of the gallbladder.
- CHOLELITHIASIS - calculi, or
gallstones, usually form in
the gallbladder from the
solid constituents of bile.
 CHOLECYSTITIS: 2 types;

1. Calculous cholecystitis
- a gallbladder stone
obstructs bile outflow.
 CHOLECYSTITIS: 2 types;

2. Acalculous
cholecystitis -
 Risk factors;

1. Cholesterol gallstone
• Obesity
• Use of estrogen and oral
contraceptives
• Cholesterol lowering
drugs
 Risk factors;

2. Pigment gallstone
• Chronic hemolysis
• Chronic liver disease
• Biliary infection
• Obstruction of
gallbladder or bile ducts
 Clinical Manifestations:
• Pain
Assessment & Diagnostic findings:

• Endoscopic retrograde
cholangiopancreatography (ERCP)
• Ultrasonography
• RADIONUCLIDE IMAGING OR
CHOLESCINTIGRAPHY
Medical Management:

• NPO
• Ursodeoxycholic acid (UDCA) and
chenodeoxycholic acid (CDCA)
• Antibiotic therapy – Levofloxacin and
Metronidazole
Medical Management:
• Promethazine or Prochlorperazine

• Surgical management: cholecystectomy

(surgical removal of gallbladder) or
cholelithotomy (removal of gallstone)
Cholecystectomy or Cholelithotomy
Nursing Management:

• Administer prescribed analgesics.

• Provide complete bedrest
• Encourage use of relaxation techniques and
provide diversional activities
• Food planning and promote appetite
PANCREATITIS

- Is an inflammation of
the pancreas.
- Pancreatitis is
commonly described
as autodigestion of
the pancreas.
Pathophysiology
• Premature activation of
trypsin and lipase enzymes
• Autodigestion and
inflammatory process
procedure
• Fibrosis or nodules formation
in pancreatic tissue
•
 Clinical Manifestations:
• Severe abdominal
• Board-like abdomen
• Ecchymosis (Cullen’s
sign)
• Skin discoloration in
flank region (Turner’s
sign
Diagnostic Findings:

• Serum amylase and lipase

levels
• WBC count
• X-ray studies
 Medical Management:
• Pain management
• Intensive care
• Aggressive respiratory care
• Biliary drainage
• Surgical management
Nursing Management:
• Maintain fluid & electrolyte balance
• Provide comfort and rest to patient
• Improve nutritional status – high in
carbohydrates and low in fats and proteins
between acute attacks
• Provide pre-post operative care
• Health education
• Restrict alcohol intake