Saturday, 17 September 2016

EMPHYSEMATOUS CHOLECYSTITIS

EMPHYSEMATOUS CHOLECYSTITIS




Q. What is the diagnosis in this diabetic woman?
(a) Toxic megacolon
(b) Emphysematous cholecystitis
(c) Ileus
(d) Diverticular disease
(e) Volvulus










Ans: b.
 The diagnosis here is emphysematous cholecystitis because air can be seen in the wall of the gallbladder. The condition, due to infection, most commonly occurs in elderly female diabetics and is usually caused by coliforms.


Causes of gas in the biliary tree
Within the bile ducts
1.      Incompetence of the sphincter of Oddi following sphincterotomy, passage of a
gallstone or in the elderly (‘patulous sphincter’)
2.      Postoperative cholecystectomy or choledochoenterostomy
3.      Spontaneous biliary fistula due to passage of gallstone from gallbladder to bowel,
duodenal ulcer perforating into common bile duct, tumour or malignancy

Within the gallbladder-
• Emphysematous cholecystitis 




 

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