Acute cholecystitis

doi:10.1136/bmj.325.7365.639

BMJ 2002;325:639-643 ( 21 September )

Clinical review

Acute cholecystitis

Adrian A Indar, surgical fellow, Ian J Beckingham, consultant hepatobiliary and laparoscopic surgeon.

Section of Gastrointestinal Surgery, University Hospital Nottingham, Nottingham NG7 2UH

Correspondence to: I J Beckingham Ian.Beckingham@nottingham.ac.uk

The first 150 words of the full text of this article appear below.

Patients with suspected acute cholecystitis should be referred to hospital and, if the diagnosis is confirmed, early surgeryis indicated

Acute cholecystitis $---$ inflammation of the gall bladder $---$ is most often caused by gall stones. Gall stones are one of the mostcommon disorders of the gastrointestinal tract, affecting about10% of people in Western society. ¹ ² More than 80% of peoplewith gall stones are asymptomatic. Acute cholecystitis developsin 1-3% of patients with symptomatic gall stones.³

Helminthic infection (ascariasis) is a major cause of biliary disease in developing countries in Asia, southern Africa, andLatin America.⁴ Obstruction of the cystic duct causes an inflammatoryprocess to start. This results in acute cholecystitis. If theinflammation persists it may cause perforation or gangrene ofthe gall bladder.

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Diagnosis of acute cholecystitis is made on the basis of clinical features and is supported by results of ultrasound scanning.Treatment is predominantly surgical, . . . [Full text of this article]

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