The following article comes from the Health Squeezing Machine, the author is Health Squeezing Machine
Recently, there was a news report that a lady in Wuhan took zongzi as a staple food for three meals during the Dragon Boat Festival, but she didn't expect to go to the hospital with a problem with eating.
Ms. Shi, 55, who just retired this year, received various flavors of zongzi before the Dragon Boat Festival. She didn't want to waste it, so she ate zongzi as a staple food for three meals a day. On the morning of June 9, she suddenly felt a dull pain in her stomach, but she didn't pay much attention to it when she thought that she had just had a physical examination in April. In order not to waste it, she ate half of the bacon dumplings at noon at dinner, but the pain in her abdomen quickly worsened, and she couldn't sleep in the middle of the night, so her family quickly sent her to the hospital for treatment.
Image source: 123RF
After examination, Ms. Shi was diagnosed with acute cholecystitis caused by cholestasis and was transferred to a gallstone disease hospital for further treatment.
Data show that in patients aged 50 years and younger, the incidence of acute cholecystitis in women is 3 times higher than that in men, and in patients over 50 years of age, the incidence of acute cholecystitis in women is about 1.5 times that of men.
Today, let's take a look at the disease of acute cholecystitis.
What is acute cholecystitis?
The gallbladder grows on our upper abdomen, on the lower side of our liver, like a "small gourd", and is very small.
▲Location of the liver, gallbladder, and bile ducts. Image source: 123RF
Despite its small size, it is specially designed to hold the bile produced by the liver. When we eat, bile flows from the bile ducts into the intestines, where it is used to digest the fats in the food.
The main components of bile are cholesterol, bile salts, and bilirubin. Among them, cholesterol and bilirubin are the main components of gallstones. If the function of the gallbladder is destroyed due to a variety of reasons, the bile composition and physical and chemical properties change, and the cholesterol, bilirubin, calcium salt, etc. in it are supersaturated, they will begin to precipitate and precipitate and become hard gallstones; If bile is not emptied completely, it also increases the risk of gallstone formation.
Ninety-five percent of acute cholecystitis is related to bile duct obstruction caused by gallstones, which are often caused by a high-fat diet. In addition to a high-fat diet, other poor eating habits, obesity, diabetes, smoking, drinking, and sitting for a long time can also form gallstones, which can lead to cholecystitis.
Image source: 123RF
Acute cholecystitis often attacks after meals and at night, especially after eating fatty and fatty foods.
There are 4 typical symptoms that are common at the onset of the disease:
- Persistent, severe pain in the upper right abdomen that worsens with pressure or deep breathing;
- Pain that spreads to the right shoulder or back;
- nausea, vomiting;
- There may also be a systemic inflammatory reaction, such as fever, and blood tests may reveal elevated white blood cell counts and elevated C-reactive protein.
How is cholecystitis treated?
Once acute cholecystitis is diagnosed, patients should immediately fast and replace fluids and electrolytes to maintain acid-base balance. Antimicrobials and analgesics should be used early.
It is important to emphasize that cholecystectomy is the fundamental treatment for acute calculous cholecystitis. No antimicrobial therapy is a substitute for treatment to relieve cystic duct obstruction. Treatment is based on a comprehensive assessment of the severity of the condition, the patient's physical status, and comorbidities.
Image source: 123RF
1. Treatment of mild acute cholecystitis
For patients with low surgical risk, gallbladder removal should be performed as soon as possible; If the risk is high, doctors may consider conservative management and make a decision about gallbladder removal until the general condition improves.
2. Treatment of moderate acute cholecystitis
Gallbladder removal may be performed in patients who respond to antimicrobial and systemic therapies and have a low risk of surgery. However, if the surgical risk is high-risk, conservative treatment should be selected for the time being.
3. Treatment of severe acute cholecystitis
Systemic organ function should be stabilized initially with antimicrobial agents and systemic support. Second, the doctor may evaluate whether cholecystectomy, gallbladder drainage, or other conservative treatment should be taken further based on the patient's physical condition, hospital treatment equipment, etc.
Resources
[1]粽子当饭吃 女子吃出急性胆囊炎. Retrieved Jun 27, 2024 from http://news.cnhubei.com/content/2024-06/13/content_18042206.html
[2] Gallstones.Retrieved Jun 27, 2024 from https://medlineplus.gov/ency/article/000273.htm
[3]epidemiology. Retrieved Jun 27, 2024 from https://bestpr
[2] Gallstones.Retrieved Jun 27, 2024 from https://medlineplus.gov/ency/article/000273.htm
[3]epidemiology. Retrieved Jun 27, 2024 from https://bestpractice.bmj.com/topics/zh-cn/3000084/epidemiology
[4] Biliary Surgery Group, Chinese Society of Surgery, Guidelines for the Diagnosis and Treatment of Acute Biliary System Infection (2021 Edition)[J]. Chinese Journal of Surgery, 2021, 59(6): 422-429. DOI:10.3760/cma.j.cn112139-20210421-00180.