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Acute Cholecystitis


Among inflammatory diseases of bile ducts the most frequent is cholecysti­tis or the inflammation of the gallbladder. Cholecystitis is known to occur rarely in isolated condition, inflammatory processes 'both in the intrahepatic and extra-hepatic ducts, sometimes with the involvement of the liver being associated with it. The main forms of cholecystitis are the following: catarrhal, purulent and gangrenous.
The patient with cholecystitis is known to complain of intense pain, it being localized in the right hypochondrium and in the umbilical area. An attack of pain is usually preceded by physical and mental overstrain, sharp physical move­ments or abnormalities in diet, fatty food and alcohol being responsible for the onset of pain. But sometimes pain is observed to appear suddenly in quite healthy persons. Pain may radiate to the right shoulder, right arm, sternum, and lumbar area, its intensity depending on the form of cholecystitis and the patient's sensi­tivity. The pain grows much worse when the patient is lying on his right side.
Dryness in the mouth, vomiting, nausea, and constipation are the character­istic clinical manifestations of the disease.
During the attack of pain the face is moist with cold perspiration, the skin is pale, the tongue and lips are dry. Even a slight palpation reveals severe tender­ness, it being due to irritation of the peritoneum. Approximately in 40-50% of cases there is slight jaundice of sclera. The biochemical blood analysis is known to reveal some changes, they resulting from the effect of toxic substances in the liver.

O'tkir xoletsistit

Safro yo'llarining yallig'lanish kasalliklari orasida xoletsistit yoki o't pufagining yallig'lanishi tez-tez uchraydi. Xoletsistit kamdan-kam hollarda izolyatsiya qilingan holda, yallig'lanish jarayonlari ham jigar ichi, ham jigar tashqarisidagi kanallarda, ba'zida esa unga jigar qo'shilishi bilan ma'lum. Xoletsistitning asosiy shakllari quyidagilar: kataral, yiringli va gangrenoz.

Xoletsistit bilan og'rigan bemor kuchli og'riqdan shikoyat qiladi, u o'ng hipokondriyumda va kindik sohasida joylashgan. Og'riq xuruji odatda jismoniy va ruhiy haddan tashqari kuchlanish, o'tkir jismoniy harakatlar yoki ovqatlanishdagi g'ayritabiiy holatlar, yog'li ovqat va alkogol og'riq paydo bo'lishiga sabab bo'ladi. Ammo ba'zida og'riq juda sog'lom odamlarda to'satdan paydo bo'lishi kuzatiladi. Og'riq o'ng elka, o'ng qo'l, sternum va bel sohasiga tarqalishi mumkin, bu uning intensivligi xoletsistit shakliga va bemorning sezgirligiga bog'liq. Bemor o'ng tomonida yotganda og'riq ancha kuchayadi.

Og'izdagi quruqlik, qusish, ko'ngil aynish va ich qotish kasallikning o'ziga xos klinik ko'rinishidir.

Og'riqqa qarshi hujum paytida yuz sovuq ter bilan namlanadi, terisi oqaradi, til va lablar quriydi. Hatto engil palpatsiya paytida ham qattiq sezgirlik paydo bo'ladi, bu qorin parda tirnash xususiyati tufayli. Taxminan 40-50% hollarda skleraning engil sariqligi mavjud. Biyokimyasal qon tahlilida jigarda toksik moddalar ta'siridan kelib chiqadigan ba'zi o'zgarishlar aniqlangan.