Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- 42 Acute Viral Hepatitis
- 43 Chronic Hepatitis
- 44 Biliary Infection: Cholecystitis and Cholangitis
- 45 Pyogenic Liver Abscess
- 46 Infectious Complications of Acute Pancreatitis
- 47 Esophageal Infections
- 48 Gastroenteritis
- 49 Food Poisoning
- 50 Antibiotic-Associated Diarrhea
- 51 Sexually Transmitted Enteric Infections
- 52 Acute Appendicitis
- 53 Diverticulitis
- 54 Abdominal Abscess
- 55 Splenic Abscess
- 56 Peritonitis
- 57 Whipple's Disease and Sprue
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
44 - Biliary Infection: Cholecystitis and Cholangitis
from Part VII - Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- 42 Acute Viral Hepatitis
- 43 Chronic Hepatitis
- 44 Biliary Infection: Cholecystitis and Cholangitis
- 45 Pyogenic Liver Abscess
- 46 Infectious Complications of Acute Pancreatitis
- 47 Esophageal Infections
- 48 Gastroenteritis
- 49 Food Poisoning
- 50 Antibiotic-Associated Diarrhea
- 51 Sexually Transmitted Enteric Infections
- 52 Acute Appendicitis
- 53 Diverticulitis
- 54 Abdominal Abscess
- 55 Splenic Abscess
- 56 Peritonitis
- 57 Whipple's Disease and Sprue
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Infectious and inflammatory disorders of the gallbladder and bile ducts are referred to, respectively, as cholecystitis and cholangitis. Most of these disorders involve acute bacterial infections and can be quite serious or even life-threatening problems that require prompt diagnosis and treatment. This chapter discusses the pathogenesis, diagnosis, and current treatment of both acute cholecystitis and acute cholangitis.
ACUTE CHOLECYSTITIS
Acute cholecystitis refers to acute inflammation of the gallbladder. Ninety-eight percent of episodes of acute cholecystitis exhibit cystic duct obstruction on radionucleotide (hydroxy iminodiacetic acid; HIDA) scan, indicating that the process most often begins with obstruction of the cystic duct by a gallstone. In about 2% to 5% of cases termed acute acalculous cholecystitis, no gallstones are present, although some cases still exhibit obstruction of the cystic duct from fibrosis or edema. Acute acalculous cholecystitis is most often found in debilitated or critically ill patients who have not been fed by mouth for extended periods of time leading to nonemptying of the gallbladder and stasis of bile in its lumen. A cascade of events triggered by gallstones, stasis, or cystic duct obstruction result in inflammation in the wall of the gallbladder, superinfection with bacteria, and eventually compromise of the gallbladder wall (Figure 44.1).
If unchecked, gangrene of the gallbladder develops and perforation of the gallbladder with abscess formation or generalized perforation ensues.
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- Chapter
- Information
- Clinical Infectious Disease , pp. 321 - 326Publisher: Cambridge University PressPrint publication year: 2008