1. Dr. Soumar Dutta Guwahati Refinery Hospital

2. Anatomy

5. EFFECTS AND COMPLICATIONS OF GALLSTONES In the gall bladder silent stone perforation Ac. Cholecystitis empyema Chr. Cholecystitis mucocele Gangrene carcinoma In the bile duct: obstructive jaundice cholangitis Acute pancreatitis In the intestine: Acute intestinal obstruction [gallstone ileus]

6. CHOLECYSTITIS: It is an inflammatory condition of the gall bladder. 1. Acute 2. Chronic (a) Secondary chronic cholecystitis (b) Primary chronic cholecystitis ACUTE CHOLECYSTITIS: 90% associated calculi PATHOLOGY . Obstruction or stasis . Chemical irritation . Bacterial Infection

7. Clinical features: Dyspeptic symptoms. Right subcostal pain Pyrexia Jaundice Investigation: Routine blood ECG USG(upper abdomen ) X-Ray of the abdomen cholescintigraphy Treatment: conservative treatment followed by cholecystectomy Nasogastric aspiration and IV fluid administration Analgesics Broad spectrum antibiotics surgical treatment: Cholecystectomy

8. Chronic Cholecystitis Two variety: secondary chronic cholecystitis primary chronic cholecystitis Clinical features: vague and insidious in onset Intolerance to fatty food Belching Postcibal epigastric distension Nausea and vomiting. Pain usually follows meal Investigations: Blood routine Oral cholecystography USG Treatment: Cholecystectomy is the definitive treatment

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