The causes of cholecystitis in humans can be various chronic diseases, or structural changes in some vessels of the biliary tract. It can also develop due to diseases of the stomach (only those accompanied by dyscholy). The main guideline in determining the disease is the symptom of Kera.
Common symptoms of cholecystitis
Depending on the localization of inflammation or changes in the structure of blood vessels and biliary tract, there are many symptoms of the disease:
- dull pain in the region of the right hypochondrium, which spreads upward - into the region of the right shoulder blade, clavicle and shoulder; with the development of the disease, the pain becomes more acute and intense;
- nausea and vomiting that provokes pain;
- taste of bitterness in the mouth;
- the presence of bile impurities in the vomit;
- the tongue is overlaid and overdried;
- fever and chills are possible;
- in case of disease progression, tachycardia and increased blood pressure are detected;
- if the lumen of the biliary tract is blocked (if there are stones in it), then a person develops pronounced jaundice;
- pain on palpation in the right hypochondrium.
In addition to the above, the main symptom of the disease is a symptom of Kera. It is expressed in pain on palpation in the area of placement of the diseased organ. With the development of the disease, the pain has an increasing character and spreads less localized.
Specific symptoms of cholecystitis
Special manifestations of the disease include symptoms of Kera and Ortner. Further examination occurs after confirmation of the presence of these manifestations. To detect the first symptom, it is enough to deep palpate the right hypochondrium, in this case the patient will have severe acute pain.
Ortner's symptom is detected by tapping the costal arch on the right side with the edge of the palm of the hand. In the presence of the disease, all manipulations will be accompanied by painful sensations of varying degrees, depending on how much the disease has developed, and what is the age and general state of human health.
In addition to them, they also distinguish:
- Obraztsov's symptom - when a person inhales and pain intensifies during palpation;
- Murphy's symptom - inability to inhale with deep palpation in the right hypochondrium;
- symptom of Mussi-Georgievsky - upon palpation of the sternocleidomastoid muscle (in the area of its legs), the patient displays a manifestation of painful sensations.
Laboratory blood tests may show neutrophilia, leukocytosis, and lymphopenia.
When do symptoms appear?
Using the symptom of Kera, it is possible to determine the presence of stoneless cholecystitis. In the presence of stones in the gallbladder or biliary tract, other symptomatic manifestations are distinguished.
Symptom of Kera in acute cholecystitis is the appearance of pain in the gallbladder during deep palpation at the location of the diseased organ.
Disease differentiation
Acute cholecystitis can be differentiated with a duodenal ulcer or stomach, as well as acute pancreatitis, appendicitis or renal colic. In order not to confuse these diseases, it is important to be able to distinguish them.
With peptic ulcers, the pain occurs sharply, moreover, it is quite acute, while with cholecystitis in the liver, the pain is dull and increases slightly over time. Also, there is a temperature in the region of 38 degrees and vomiting with bile.
In acute pancreatitis, the pain is localized in the left hypochondrium, and can also be accompanied by continuous vomiting.
Acute appendicitis does not have pain in its symptoms , radiating to the shoulder and shoulder blade, and also does not manifest vomiting. With appendicitis, the patient has no symptom of Kera and Musse.
With renal colic, an increase in temperature and the presence of leukocytosis in the blood are not observed. The pain is localized mainly in the lumbar region and extends to the hips and pelvic organs.
Treatment of cholecystitis
Treatment of cholecystitis should begin before the hospitalization of the patient. Intravenously injected drugs that help reduce pain (most often, an injection solution of “No-shpa” is used), and reduce pressure in the gallbladder, due to improved outflow of bile into the small intestine.
Symptom of Kera with cholecystitis is the reason for the immediate hospitalization of the patient with subsequent surgical or conservative intervention by medical staff.
Timely attention paid to the presence of the described symptoms and the ability to distinguish them from differential diseases helps to increase the chance of a quick recovery without surgical intervention.