Diseases of the Gallbladder. Gallstones may remain in the gallbladder indefinitely without causing any symptoms until they attempt to pass through ducts. Bacteria, especially typhoid bacilli, can produce gallstones and cause inflammation that leads to stone formation. Jaundice will not be a symptom if the stone lodges in the cystic duct; plugging of the common duct causes atrophy of the gallbladder. An attack of gallstone colic is abrupt with severe pain in the right hypochondriac region, radiating to the shoulder or arm. Rigors and fever follow, along with vomiting and sweating. The pulse becomes weak and rapid, and tenderness over the area of the gallbladder can be found.
<Callout type="important" title="Critical Symptoms">An attack of gallstone colic is characterized by sudden onset of severe pain in the right hypochondriac region, often radiating to the shoulder or arm. Rigors and fever are common symptoms.</Callout>
Treatment for acute attacks involves relieving spasmodic contraction with atropine sulfate (gr. %o) injected subcutaneously, followed by a hot-water bath if no relief is obtained within one hour. Morphine may be used if pain persists after two hours. Olive oil and glycerin are thought to assist in passing stones.
Suppurative cholangeitis is often caused by gallstones but can also result from typhoid, grip, cancer of bile ducts, or hydatid disease. Symptoms include progressive hepatic enlargement, persistent icterus, fever, rigors, and profuse perspiration. The pancreatic ducts are frequently involved leading to a pancreatic abscess.
<Callout type="risk" title="Severe Complications">Suppurative cholangeitis can lead to severe complications such as pancreatic abscesses due to the proximity of the pancreas to the bile ducts.</Callout>
Treatment for suppurative cholangeitis is entirely surgical, and a physician should advise operation if the patient is in condition to endure it.
Key Takeaways
- Gallstones can remain symptomless until they attempt to pass through ducts.
- Jaundice is not a symptom if the stone lodges in the cystic duct.
- Suppurative cholangeitis requires surgical intervention.
Practical Tips
- Use atropine sulfate for relieving spasmodic contraction during an acute attack of gallstone colic.
- Administer morphine if pain persists after two hours without relief from other treatments.
- Consider olive oil or glycerin as possible aids in passing stones.
Warnings & Risks
- Do not administer excessive doses of atropine to avoid poisoning the patient.
- Suppurative cholangeitis can lead to severe complications such as pancreatic abscesses if left untreated.
Modern Application
While some treatments like atropine and morphine are still relevant today, modern medical practices have advanced significantly. Surgical interventions for gallbladder issues are now more common and less risky due to advancements in technology and surgical techniques.
Frequently Asked Questions
Q: What are the symptoms of an acute attack of gallstone colic?
An acute attack of gallstone colic is characterized by sudden onset of severe pain in the right hypochondriac region, often radiating to the shoulder or arm. Rigors and fever are common symptoms.
Q: What treatment should be administered during an acute attack of gallstone colic?
Treatment involves relieving spasmodic contraction with atropine sulfate (gr. %o) injected subcutaneously, followed by a hot-water bath if no relief is obtained within one hour.
Q: What are the causes and symptoms of suppurative cholangeitis?
Suppurative cholangeitis can be caused by gallstones but also typhoid, grip, cancer of bile ducts, or hydatid disease. Symptoms include progressive hepatic enlargement, persistent icterus, fever, rigors, and profuse perspiration.