It is an acute inflammation of the gallbladder. Infection may be mild to moderate. The condition usually resolves with conservative management, but may lead to gangrene, perforation or abscess formation.
Unremitting & presenting with more severe pain than biliary colic. Pain in right upper quadrant or epigastrium associated with anorexia, nausea, vomiting, or chills.
- Fever is usually present.
- A tender mass is usually palpable in the right hypochondrium.
- Mild jaundice may be present. Moderate to severe jaundice suggests presence of inflammation or obstruction of common bile duct.
- TLC is markedly raised. (12000 to 15000 cmm/L). A TLC more than 20,000 suggests gangrene, perforation, or cholangitis.
- LFTs are usually slightly raised.
- Ultrasonography confirms the diagnosis.
- Hospital admission.
- Nothing orally till nausea and vomiting settles.
- I/V fluids.
- I/V antibiotics (2nd 0r 3rd generation cephalosporins).
Inj. Diclofenac sodium 75 mg deep intragluteal BD for 48 hours
Inj. Nalbufin 0.3mg/kg I/V x 6 hourly
Tab. Paracetamol 2 x TDS
Tab. Naproxen sodium 2 x TDS
Cap. Campax 50mg 1 x BD
Conservative management is reassessed frequently. If the patient is improving clinically, she may undergo early cholecystectomy on next available elective list if patient does not improve or deteriorates then consider:
1- Change of antibiotic or
2- Emergency cholecystectomy.