3B / BBB

4F pada kelainan empedu

• Female

• Forty

• Fertile

• Fat

90% batu empedu ada di...

• Common hepatic duct

• Pancreatic duct

• Common bile duct

• Cystic duct

Etiology acute cholecystitis

• Mechanical inflammation (increased intraluminal pressure)

• Chemical inflammation (Lisolecythin)

• Bacterial inflammation

• Slow gastric emptying (jarang nutrisi -> ga ngeluarin cairan empedu -> stasis)

Acalculous Cholecystitis

• Wihout stone

• Serious trauma or burns

• Vasculitis, adenoCA, DM

Trias acute cholecystitis

• Demam

• Nyeri RUQ

• Leukocytosis

Gejala acute cholecystitis

• Nyeri menjalar ke pundak/ scapula kanan

• urine may be dark

• peritoneal sign (+)

• Murphy Sign (+)

Dx

Empyema acute cholecystitis (common complication)

• nyeri progresif

• suhu tinggi

• menggigil

• leukocytosis berat

Tx acute cholecystitis

• Cholecystectomy (obstruction/ gallstone)

• ERCP

• IV fluid, antibiotics

• Empyema -> percutaneous drainage

Etiology Appendicitis

• Fecalith

• Gallstones

• bacteria, virus

• IBD/ hyperplasia lymphoid