Home Forums IMASS Forum Colecistita

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    • #553 Reply
      cococeanu
      Participant

      Care sunt simptomele acestei afectiuni?

    • #2901 Reply
      Rosu Luka
      Guest

      Este necesara manevra Murphy pentru stabilirea diagnosticului de colecistita?

      • #3502 Reply
        comanadina
        Moderator

        Manevra Murphy:manevra ce consta in plasarea mainii medicului examinator sub rebordul costal drept in timp ce pacientul este invitat sa inspire profund, este pozitiva (determina durere vie la palparea colecistului) in caz de colecistita acuta. Mai multe informatii gasiti pe acest site la sectiunea pacienti/patologia abdominala.

    • #2967 Reply
      Andreea
      Guest

      Icterul intermitent poate fi cauzat de colecistita acuta litiazica?

      • #3503 Reply
        comanadina
        Moderator

        Icterul intermitent apare in principal in dilatatiile congenitale de cai biliare principale la adult, dar poate apare si in cazul unei colecistite acute litiazice cu calculi mici care pot trece prin canalul (legatura dintre colecist si intestin) coledoc ( de pasaj) obstruandu-l pentru o perioada de timp dupa care daca sunt suficient de mici pot ajunge in intestin si icterul dispare. Mai multe informatii gasiti pe site la sectiunea pacienti/patologie abdominala.

    • #2968 Reply
      Catalina
      Guest

      De ce mai apar la unele persoane simptome tip colecistita post colecistectomie?

      • #3512 Reply
        comanadina
        Moderator

        Buna ziua,
        In urma colecistectomiei este indepartat chirurgical colecistul (fierea, rezervorul de bila). Bila este produsa de catre ficat, si o parte este depozitata in colecist; Restul trece prin calea biliara principala (coledoc) in intestin. Fiziologic colecistul (vezicula biliara, fierea) are rolul de a pompa bila in intestin (duoden) pentru a ajuta la digee (emulsionarea grasimilor). Daca colecistul este blocat de pietre sau exclus chirurgical, nu mai functioneaz/exista rezervorul de bila, si, in cazul unei mese bogate in grasimi sau substante colecistokinetice, bila produsa de ficat va ajunge in duoden in mod constant, nefiind disponibil rapid o cantitate mare de bila. Astfel mesele bogate in grasimi vor fi digerate mai greu si atunci pot aparea simptome ca durere in partea dreapta a abdomenului superior, sub rebordul costal, balonare, greturi, varsaturi etc

    • #2972 Reply
      AndreeaM
      Guest

      De ce nu apare icterul in hidropsul vesicular?

      • #3511 Reply
        comanadina
        Moderator

        Buna ziua,
        Intai as dori sa dau o definitie a hidropsului vezicular. Hidropsul vezicular reprezinta situatia in care colecistul (vezicula biliara, fierea, rezervorul de bila) este dilatat si umplut cu conţinut mucoid sau clar (bila alba), avand ca si cauza principala litiaza biliară (calcul blocat in portiunea inferioara a veziculei biliare). Dupa aceasta definitie, doar vezicula biliara este afectata, calea biliara principala (coledocul)- canalul prin care trece bila din colecist-canal cistic si de asemenea din ficat in intestin (duoden) este libera (fara calculi). Deci bila trece din ficat (locul in care se produce) in duoden, doar bila din rezervor (colecist)nu trece si astfel icterul mecanic nu apare. Icterul mecanic poate apare si in hidropsul vezicular in situatii exceptionale: prin compresiune extrinseca a canalului coledoc de catre colecistul mult dilatat sau daca unul dintre calculi a migrat in canalul coledoc.

    • #2977 Reply
      Micu Adriana
      Guest

      În ce situație se recomandă intervenția chirurgicală de urgență în cadrul unui bloc apendicular?

      • #3510 Reply
        comanadina
        Moderator

        In cazul blocului apendicular (plastronului apendicular) abcedat sau abces+fistula in organele invecinate, se impune tratament chirurgical de urgenta constand din evacuarea si drenajul abcesului sau o interventie chirugicala mai extinsa in cazul prezentei fistulei in organele invecinate. Interventia chirurgicala se poate realiza atat pe cale clasica cat si pe cale laparoscopica.

    • #3501 Reply
      comanadina
      Moderator

      Simptomele colecistitei: durere in hipocondrul drept (in abdomenul superior, in partea dreapta sub coaste), greturi, varsaturi, gust amar, balonare. Mai multe informatii gasiti pe acest site la sectiunea pacienti/patologie abdominala.

    • #3637 Reply
      Elena
      Guest

      Pacient cunoscut cu calculi la fiere si cu antecedente de trecere a unui calul pe canalul principal. Se recomanda indepartarea fierei? Iar daca nu, care sunt consecintele daca o lasam pe loc?

      • #6527 Reply
        comanadina
        Moderator

        Buna ziua,
        Indepartarea colecistului are indicatie absoluta in aceste caz, pentru evitarea unor complicatii ca icterul mecanic (treceerea pietrelor in canalul principal), angiocolita (infectia bilei datorate existentei calculilor in canalul coledoc), pancreatita.

    • #7121 Reply
      Xc
      Guest

      Care sunt etiologiile colecistitei acute non-litiazice? și poate fi considerată mai gravă decât forma litiazică?

      • #7499 Reply
        comanadina
        Moderator

        Colecistita acuta non litiazica apare cu o frecventa mult mai rara decat colecistita acuta litiazica. Factorii incriminati pentru aparitia acesteia sunt reprezentati de obstacole in colecist sau in afara acestuia (ex. Polipi voluminosi, tuomori ale colecistului sau tumori ale organelor invecinate) care determina colecistita acuta primitiva. Colecistita acuta secundara- apare in stari septtice (ex.Salmonella). Colecistita acuta non-litiazica poate aparea si in unele boli parazitare (echinococoza, lambliaza, ascaridioza). Colecistita acuta ischemica determinata de obstructia trombo-embolica a arterei cistice (ex. ateroscleroza, diabetul zaharat). Aceste forme sunt mai grave dat fiind cauzele incriminate in producerea cloecistitei acute litiazice si terenul (organism tarat).

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