COMPLICATED CHOLECISTITIS

The most common obstructive sequela of gallstones occurs in the cystic duct, which results in cholecystitis and usually requires a permanent drainage procedure (cholecystectomy) or temporizing drainage procedure (cholecystostomy tube).

• YES

• NO

Mirizzi syndrome can lead to compression or erosion of gallstones into the pancreatic duct.

• YES

• NO

Acalculous cholecystitis may also occur in 15% to 20% of patients who present with cholecystitis

• YES

• NO

One of this events is not present in acute cholecistitis setting:

• Severe, constant right upper quadrant pain lasting more than 6 hours

• Self limited

• Fever

• Vomiting

All of these findings are common in assessment gallbladder ultrasound examination, except one. Mark it:

• Wall thickening of more

  than 5 mm

• Pericholecystic fluid

• Presence of gallstones

• Aperistaltic gallbladder

Related with the treatment, compared with delayed cholecystectomy, early cholecystectomy for cases within 72 h of patient presentation or symptom onset was associated with better results.

• YES

• NO

Elective cholecystectomy after the improvement of the acute inflammatory process could be indicated in the poor conditional patients.

• YES

• NO

When antibiotics are used as the only therapy, pain will usually recur and persist, as may infection or sepsis because the gallbladder is not drained.

• YES

• NO