Chronic cholecystitis pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
=== | ===Chronic Cholecystitis=== | ||
Gallstones are one of the major causes of cholecystitis. These cause physical obstruction to the lumen of the neck or cystic duct. This results in an increase in the intraluminal pressure. The degree and duration of obstruction are the two main factors that determine its progression. | Gallstones are one of the major causes of cholecystitis. These cause physical obstruction to the lumen of the neck or cystic duct. This results in an increase in the intraluminal pressure. The degree and duration of obstruction are the two main factors that determine its progression. | ||
* Partial obstruction of short duration may cause biliary colic. Long-term obstruction may progress to chronic cholecystitis. | |||
Some studies suggest that the pancreatic biliary reflux plays a role as a co factor for the development of chronic cholecystitis. Occult pancreatic biliary reflux can be diagnosed by measuring the levels of biliary amylase. <ref name="pmid22662601">{{cite journal |author=Amr AR, Hamdy HM, Nasr MM, Hedaya MS, Hassan AM |title=Effect of pancreatic biliary reflux as a cofactor in cholecystitis |journal=[[Journal of the Egyptian Society of Parasitology]] |volume=42 |issue=1 |pages=121–8 |year=2012 |month=April |pmid=22662601 |doi= |url= |accessdate=2012-08-20}}</ref><ref name="pmid11483446">{{cite journal |vauthors=Kalloo AN, Kantsevoy SV |title=Gallstones and biliary disease |journal=Prim. Care |volume=28 |issue=3 |pages=591–606, vii |year=2001 |pmid=11483446 |doi= |url=}}</ref><ref name="pmid10750875">{{cite journal |vauthors=Ahmed A, Cheung RC, Keeffe EB |title=Management of gallstones and their complications |journal=Am Fam Physician |volume=61 |issue=6 |pages=1673–80, 1687–8 |year=2000 |pmid=10750875 |doi= |url=}}</ref> | Some studies suggest that the pancreatic biliary reflux plays a role as a co factor for the development of chronic cholecystitis. Occult pancreatic biliary reflux can be diagnosed by measuring the levels of biliary amylase. <ref name="pmid22662601">{{cite journal |author=Amr AR, Hamdy HM, Nasr MM, Hedaya MS, Hassan AM |title=Effect of pancreatic biliary reflux as a cofactor in cholecystitis |journal=[[Journal of the Egyptian Society of Parasitology]] |volume=42 |issue=1 |pages=121–8 |year=2012 |month=April |pmid=22662601 |doi= |url= |accessdate=2012-08-20}}</ref><ref name="pmid11483446">{{cite journal |vauthors=Kalloo AN, Kantsevoy SV |title=Gallstones and biliary disease |journal=Prim. Care |volume=28 |issue=3 |pages=591–606, vii |year=2001 |pmid=11483446 |doi= |url=}}</ref><ref name="pmid10750875">{{cite journal |vauthors=Ahmed A, Cheung RC, Keeffe EB |title=Management of gallstones and their complications |journal=Am Fam Physician |volume=61 |issue=6 |pages=1673–80, 1687–8 |year=2000 |pmid=10750875 |doi= |url=}}</ref> | ||
Revision as of 17:13, 5 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
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Overview
Pathophysiology
Chronic Cholecystitis
Gallstones are one of the major causes of cholecystitis. These cause physical obstruction to the lumen of the neck or cystic duct. This results in an increase in the intraluminal pressure. The degree and duration of obstruction are the two main factors that determine its progression.
- Partial obstruction of short duration may cause biliary colic. Long-term obstruction may progress to chronic cholecystitis.
Some studies suggest that the pancreatic biliary reflux plays a role as a co factor for the development of chronic cholecystitis. Occult pancreatic biliary reflux can be diagnosed by measuring the levels of biliary amylase. [1][2][3]
Acute Acalculous Cholecystitis
Gallbladder Ischemia/Reperfusion Injury[4]
- Prolonged periods of ischemia to the gall bladder leads to disruption of the normal mucosal surface.
- Lipopolysaccharides are exposed leading to activation of various coagulation cascades.
- Reperfusion leads to an increased humoral response which leads to further damage causing cholecystitis.
Bile Stasis[4]
- Loss of fluids, opioid drugs, positive pressure ventilation, and other factors cause an increased concentration of bile in the biliary tracts.
- Bile contains phosphatidyl choline, which in increased concentrations can cause mucosal disruption.
Pathology
Chornic Cholecystitis
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References
- ↑ Amr AR, Hamdy HM, Nasr MM, Hedaya MS, Hassan AM (2012). "Effect of pancreatic biliary reflux as a cofactor in cholecystitis". Journal of the Egyptian Society of Parasitology. 42 (1): 121–8. PMID 22662601. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Kalloo AN, Kantsevoy SV (2001). "Gallstones and biliary disease". Prim. Care. 28 (3): 591–606, vii. PMID 11483446.
- ↑ Ahmed A, Cheung RC, Keeffe EB (2000). "Management of gallstones and their complications". Am Fam Physician. 61 (6): 1673–80, 1687–8. PMID 10750875.
- ↑ 4.0 4.1 "Acute acalculous cholecystitis - Surgical Treatment - NCBI Bookshelf". Retrieved 2012-08-20.
- ↑ "Acute cholecystitis - Libre Pathology".