Many people do not even suspect what functions in the body perform certain organs. Only when faced with violations in their work, we begin to understand how much they are really needed. Any deviations instantly affect the well-being of a person, his mood.
One of the important organs is the gall bladder. It constantly accumulates a special secret needed to complete the digestion process. This organ is susceptible to various pathologies. Among all diseases, empyema of the gallbladder deserves special attention. Clinic, diagnosis, treatment of this insidious pathology - these are just some of the issues that we will now consider.
Disease Description
Empyema of the gallbladder is usually understood as an acute inflammatory process that develops within this organ. It is characterized by a gradual accumulation of purulent exudate. The disease is manifested by severe pain, fever, symptoms of intoxication. The development of the pathological process is possible in two ways. Inflammation passes from neighboring organs or is the result of exposure to infectious agents.
Gallbladder empyema occurs in 5-15% of patients who have had acute cholecystitis. Mostly middle-aged women with severe signs of obesity are affected. Empyema belongs to the category of progressive disorders, therefore, after its identification, immediate hospitalization is required. In the absence of adequate treatment, the probability of death of the patient is high.
Stages of pathology
Empyema of the gallbladder develops gradually. Consider each of the steps in this process.
In a healthy body, the liver actively secretes a secret that accumulates in the gallbladder. One part of it is excreted into the intestine, where it further takes part in the digestion of food. The other is resorbed by the walls of the bubble.
As a result of the inflammatory process, purulent exudate begins to develop in the body cavity. The resorptive abilities of its walls are lost. Fluid gradually builds up in the gallbladder. The inflammatory process from the serous form very quickly turns into purulent. Concomitant obstruction of the common bile duct interferes with the complete elimination of bile. Further stretching of the walls of the organ can lead to tissue atrophy.
Dropsy and empyema of the gallbladder
These two diseases have a similar etiology and clinical picture. Therefore, it is advisable to consider them together.
Dropsy and empyema of the gallbladder are most often the result of obstruction of the duct. A detached calculus or neoplasm can lead to this violation. Unlike dropsy, the development of empyema is always preceded by acute cholecystitis, i.e., the inflammatory process.
As for the clinical picture, both diseases are manifested by fever, discomfort in the right hypochondrium. Dropsy patients also complain of constant vomiting of bile and intestinal colic.
Some doctors consider dropsy to be one of the underlying causes of empyema. However, there are other factors that contribute to the development of the pathological process.
Other causes of empyema
As mentioned earlier, the disease often develops against a background of cholecystitis. The calculus clogs the ducts, and the result of this violation is inflammation. The secret inside the gallbladder gradually accumulates. It is considered a favorable environment for the life of pathogenic flora. Clostridia, staphylococcus, Klebsiella and other microorganisms can act as infectious agents.
Another common cause of the disorder is a malignant tumor. If the neoplasm is not timely removed from the bladder, the inflammatory process will continue to progress. In this case, the result for the patient is disappointing - tissue necrosis.
Doctors distinguish a group of patients who are more prone to the appearance of empyema of the gallbladder. It includes:
- overweight people;
- patients with diabetes;
- patients with various kinds of immunodeficiencies.
Determining the cause of the disease often helps to choose treatment tactics.
How to recognize the disease at an early stage?
Developing empyema of the gallbladder has symptoms similar to those characteristic of acute cholecystitis. Patients complain of discomfort in the right hypochondrium, a sharp increase in temperature. Sometimes symptoms are accompanied by severe chills.
Indirect signs of the disease include a lack of appetite, excessive sweating and dry mouth. Pain in the right hypochondrium is not always present. They can intensify with a deep breath or cough.
It is worth noting that with diabetes and immunodeficiency disorders, these symptoms are less pronounced. Therefore, patients seek medical attention too late. Lack of treatment is fraught with perforation of the bladder and sepsis. An even greater increase in temperature indicates the development of these pathological conditions. There may also be confusion, a decrease in blood pressure.
Patients with acute cholecystitis or tumors of the gallbladder need to pay special attention to their own health. When the above symptoms appear, you must immediately call a team of medical workers. Only hospitalization and proper treatment in such cases can save a life.
Medical examination
Empyema of the gallbladder is detected on the basis of patient complaints, his anamnesis and test results. The patient must tell how long the symptoms appeared, under what conditions their intensity increases, what treatment he had previously. All data is important to the doctor. Without this information, it is impossible to choose an adequate treatment.
Without fail, all patients are assigned an examination of the body. If a disease such as empyema of the gallbladder is suspected, the diagnosis includes the following measures:
- Blood analysis. An increase in white blood cells indicates an inflammatory process.
- Microbiological blood test. Allows you to determine the presence of infectious agents, their sensitivity to antibiotics.
- Blood biochemistry. Using this test, you can evaluate the liver. An increase in bilirubin activity indicates empyema.
- Ultrasound With a progressive inflammatory process, the gallbladder is usually enlarged, fluid accumulation can be seen around it.
Additionally, differential diagnosis of dropsy and empyema of the gallbladder is carried out.
Recommended Therapy
The only treatment for empyema is gallbladder removal. The operation is called "cholecystectomy." Before it, the patient is prescribed a course of antibiotics. Drug therapy helps to reduce concomitant symptoms, reduces the risk of postoperative complications.
In the initial stages of the inflammatory process , Ampicillin is used, as well as first-generation cephalosporins. If its course is complicated by sepsis or perforation of the gallbladder, more massive antibiotic therapy is required. Typically, the patient is prescribed the simultaneous administration of three drugs: "Gentamicin", "Ampicillin" and "Metronidazole". Dosage and treatment regimen are selected individually.
Cholecystectomy is carried out either through a full cavity incision, or laparoscopically. Which option to choose from, the doctor decides. After surgery, when gall bladder empyema remains in the past, antibiotic treatment is continued. The duration of therapy depends on how quickly the temperature and blood counts return to normal. Sometimes patients have to take medicine even after being discharged from the hospital.
Recipes of folk healers
Only conservative medicine can help patients with empyema. Self-medication often ends in death or leads to the development of complications.
However, some medicinal plants are used to combat one of the causes of the disease - cholecystitis. Healers advise to pay attention to horseradish. The roots of this plant help from many ailments. To eliminate the symptoms of cholecystitis, it is necessary to prepare a decoction. A glass of raw materials should be poured with a liter of hot water and left in a container under the lid. A day later, the resulting infusion needs to be filtered. Such a medicine is recommended to be stored in the refrigerator, and taken already in the form of heat in small portions.
Possible complications
Empyema of the gallbladder, provided it is detected promptly, does not pose a threat to life. The greatest danger is in the complications of the pathological process, which are not uncommon in patients with such a diagnosis.
Stretching and atrophy of the walls of the gallbladder can lead to perforation of the organ. Perforation can be of two types: covered and complete. In the latter case, peritonitis develops rapidly. When infectious agents enter the bloodstream, sepsis occurs, which is characterized in most cases by an unfavorable outcome.
Postoperative complications include wound infection and subhepatic abscess.
Prognosis for recovery
What should patients with a diagnosis of empyema of the gallbladder expect? The types and stages of any pathological process determine its outcome. If the disease is diagnosed in a timely manner, and the necessary assistance is provided to the patient, one should hope for a favorable prognosis. In case of blood poisoning, the outcome of therapy is not always positive. The probability of death of the patient with such complications is quite high.
Preventive measures
Can a disease such as empyema of the gallbladder be prevented? The signs of the pathological process, which are presented a little higher in the article, make many think about the seriousness of the disease.
To prevent its development, doctors advise to periodically undergo a complete medical examination of the body. Particular attention should be paid to pelvic ultrasound. A detailed diagnosis of the gallbladder allows you to identify any pathology at the initial stage of its development. The sooner the patient starts the prescribed treatment, the sooner he will recover.